1991, 06-05 Permit App: 91003101 ACJOB STREET ADDRESS:
CITY/STATE/ZIP:
MECHANICAL PERMIT AP1$ICATION FORM
Information 'Worsheet
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Q/-3/6/
OWNER: .Je` 613 1'-c.9-7
0 o `"r C
MAILING ADDRESS:
CONTRACTOR:
(Street)
BANNER FURNACE F, FUEL
CON'1'AC'I': RUSS LUNDE
MAILING ADDRESS:
P.O. BOX 4346
(Street)
PARCEL NUMBER:
PHONE NUMBER:
`T L2QL
(City/State) (Zip)
BANNEFF378NT
LICENSE NUMBER:
PHONE NUMBER: 535-1711
SPOKANE, WASHINGTON 99202
(City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
OF UNITS UNIT
DESCRIPTION
= AMOUNT
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000 BTU
HEATING EQUIPMENT +100;000 BTU
GAS PIPING (1 - 4 OUTLETS)
GAS PI?ING (5 OR MORE. EACH:)
REFRIG 1-100M BTU (NOT A/C OR
REFRIG 101-500M BTU
HEAT PUMP)
REFRIG 501-1,000M BTU
REFRIG 1,001-1,750M BTU
REFRIG +1,750M BTU
BEAT PUMP &
HEAT PUMP &
BEAT PUMP &
HEAT PUMP &
BEAT PUMP &
VENTILATING
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
FANS
0-3 TONS
3-15 TONS
15-30 TONS
30-50 TONS
+50 TONS
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12' OR 12'
TYPE II HOOD
CLOTHES DRYER
RANGE
GAS LOG
PTN. OF HOOD)
MISCELLANEOUS (NOT COVERED ELSEWHERE)
UNLISTED GAS APPLIANCE <400,000 BTU
UNLISTED 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
x$10.00 =
x 25.00 =
x 10.00 =
x 12.00 =
x 15.00 =
x 4.00 =
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
= $ 37 o a
Spokane Obunty Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675