1992, 09-30 Permit App: 92008256 ACMECHANICAL PERMIT APPLICATION FORM
Information Worksheet
/1(71-1 7/ 7 L4 x-44
JOB STREET ADDRESS:
CITY/STATE/ZIP:
OWNER: C'., C,
c-\ a- 'Z'a 5b
10;1
'1924 (O
MAILING ADDRESS:
PARCEL NUMBER:
PHONE NUMBER:
z 749fc
(Street) (CitylState)
CONTRACTOR: Banner Furnace & Fuei . 1nc.LICENSE NUMBER: BANNEFF378NT
CONTACT: RUSS LUNDE PHONE NUMBER: 535-1711
MAILING ADDRESS: P.O. Box 4346 Spokane, WA. 99202
(Zip)
DESCRIPTION
(Street) (CitylState)
MECHANICAL WORKSHEET/FEE SCHEDULE
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVEJINSERT
GAS WATER HEATER
GAS EQUIPMENT <100,000 STU (INCLUDDBS
GAS EQUIPMENT +100,000 BTU DUCTWORK)
GAS PIPING (EA OUTLET)
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG 101-500M BTU
BOILER/REFRIG 501-1,000M BTU
BOILERIREFRIG 1,0001-1,750M BTU
BOILER/REFRIG +1,750M BTU
HES$ AIR CONDITIONER 0-3 TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT PUMP & AIR CONDITIONER 15-30 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT PUMP & AIR CONDITIONER +50 TONS..
VENTILATING FANS
.... ...... ........ .
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE II HOOD
CLOTHES DRYER
RANGE
GAS LOG
MISCELLANEOUS (NOT COVERED ELSEWHERE
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED GAS APPLIANCE >400,000 BTU
USED APPLIANCE <400,000 BTU
USED APPLIANCE >400,000 BTU
AIR HANDLER <10,000 CFM
AIR HANDLER >10,000 CFM
SS•.Y
x 10.00 =
x 25.00 =
x 10.00 =
x12.00 =
x 15.00 =
x 1.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x100.00 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
SUBTOTAL
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
.� 7 --
Spokane
-
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675