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1992, 05-27 Permit App: 92003761 Mechanical FixturesJOB STREET ADDRESS: CITY/STATE/ZIP: OWNER: GL '" MAILING ADDRESS: MECHA$ ICAC PERMIT APPLICATION FORM ..• • a a 31 (P ( [ Intorrriation *orksfieet PARCEL NUMBER;A - recePI- ' 31 �oRo PHONE NUMBER: ,t -Y y= -/L CONTRACTOR: Banner (Street) (City/State) Furnace k Fiel_,__Inc..:LICENSE NUMBER: BANNEFF378NT PHONE NUMBER: 535-1 711 CONTACT: RUSS LUNDE MAILING ADDRESS: P.O. Box 4346 (Zip) Spokane; WA:• 199202 (Street) (City/State) MECHANICAL WORKSHEET/FEE SCHEDULE DESCRIPTION ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) WOODSTOVE/INSERT :`.:`. `' - • GAS WATER HEATER GAS EQUIPMENT <I00,000 BTU (INCLUDES 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 1,00014750M BTU BOILER/REFRIG+1,750M BTU, , HEAT PUMP & 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 B TU USED APPLIANCE <400,000 BTU USED 'APPLIANCE >400;000 -BTU AIR HANDLER <10,000 CFM AIR HANDLER >10,000.CFM "', NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE A (Zip) NUMBER OF UNITS X EACH UNIT „ „ = AMOUNT x10.00,=;, X 25.00"= *10.00 a" x12.00 =' *15.00,= x 1.00 = x 12.00 x20.00 x 25.005. x35.00= x 60.00. _ '' x12.00 = X 20.00 ='` x 25.00 = x 35.00 = ' x 60.00 5 .. * 10.00=',, x10.00 =< * 50.00 4,'. x 10.00_',. *10.00 = x 10.00.-a x10.00 = x 10.00 = *50.00 = • x100.00 x 50.00 = x100.00 x 12.00 = x 15.00 • igc.riro, _ i :/Z -a •' , .... . ,,,,,., SUBTOTAL ". ;, $ .y oa. PLUS: PROCESSING FEE _ , + $ .. 25.00 EQUALS: TOTAL PERMIT .:, . , . ,'. FEE DUE : -': _$ : y 9•a' • Spokane County Division of Buildings West 1303 Broadway Avenue Spokane; WA 99266 (509) 456-3675