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1991, 08-22 Permit App: 91005199 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM Information Worksheet ET ADDRESS: h /r 2 2r0 / de. "Pt ma OWNER: IP: 46. k rs r6 MAILING ADDRESS: CONTRACTOR: PARCEL NUMBER: PHONE NUMBER: /6 53-Y 03.20 9,26 s'.ti i (Street) (City/State) Ranner Furnas & Fuel , Tnf!LICENSE NUMBER: BANNEFF378NT CONTACT: RUSS LUNDE MAILING ADDRESS: P.O. Box 4346 PHONE NUMBER: 535-1711 Spokane, WA. (Zip) . 99202 (Street) (City/State) MECHANICAL WORKSHEET/FEE SCHEDULE DESCRIPTION ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) GAS WATER HEATER GAS EQUIPMENT.<100,000BTU (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 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 PUMP & AIR CONDITIONER'15-30 TONS • HEAT PUMP & AIR CONDITIONER 30-50 TONS ,HEAT PUMP & AIR CONDITIONER +50 TONS . - VENTILATING FANS EVAPORATIV6COOLERS'"'. •• . ... TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) :TYPE CLOTHES DRYER GAS LOG . . . ............ MISCELLANEOUS°(NOT, COVERED;ELSEWHERE• UNLISTED GAS APPLIANCE <400,000 BTU ULINSTED GAS.APPEIANCE400,000 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 (Zip) NUMBER OF UNITS X EACH UNIT = AMOUNT x 10.00 = x 25.00 = x 10.00 = x 12.00 = x 15.00 = x1.00 = 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 = / /2:::.•);(9. 1.00 I SUBTOTAL $ 1 3_ o 3 + $ 25.00 PLUS: PROCESSING FEE EQUALS: TOTAL PERMIT ' FEE DUE = $ ,3&. 00 SIGNATURE / Spokane County Division of Buildings West 1303 Broadway Avenue Spokane; WA 99260 (509) 456-3675