1991, 09-16 Permit App: 91005876 Mechanical FixturesJOB STREET ADDRESS:
CITY/STATE/ZIP:
OWNER: (/J<1yN(
MAILING ADDRESS:
MECHANICAL PERTH- APPLICATION FORM
In;ormion Worksheet
9 920 PARCEL NUMBER:
KE r-rttrosJ PHONE NUMBER:
__C// "fee -
1-1 611--o1I-7 - o?'PoruuwrTy
(Street) (City/State)
CONTRACTOR: Banner Furnace & Fuel ,_Jn LICENSE NUMBER: BANNEFF378NT
CONTACT: RUSS LUNDE
MAILING ADDRESS: P.O. Box 4346
PHONE NUMBER: 535-1711
(Zip)
Spokane, WA. 99202
DESCRIPTION
(Street)
(City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVE/INSERT
GAS WATER HEATER
GAS EQUIPMENT <100,000 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,DOOM BTU
BOILER/REFRIG-1,0001-1,750M`BTU
BOILER/REFRIG +1,750M BTU
HEAT PUMP & AIR CONDITIONER 0-3 TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT,P.UIv1P & 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 12PTN. 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
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x 25.00 =
x 10.00 =
x 12.00 =
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
x 10.00 =
x 10.00 =-
x 50.00 =
x
x 10.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 10.00 =-
x 50.00 =
x
x100.00 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
/
/e2 0':0
/_ 00
SUBTOTAL
$ /I_ oo
+ $ 25.00
PLUS: PROCESSING FEE
EQUALS: TOTAL PERMIT
FEE DUE
= $ 3d'. o o