1991, 04-04 Permit App: 91001590 Furnace, PipingJOB STREET ADDRESS:
CITY/STATE/ZIP:
IYltUIIMIUbML rtrani i ArrLIbA I IU rum' � J(
Information Worksheet J
`C� L
/1----F!.'
PARCEL NUMBER: - I) 6
OWNER: )) AyN 6 CS o0.1
MAILING ADDRESS:
PHONE NUMBER:
7.27,s44,/
?1/4
(Street) (City/State) (Zip)
CONTRACTOR: BANNER FURNACE $ FUEL LICENSE NUMBER: BANNEFF378NT
CONTACT: RUSS LUNDE
MAILING ADDRESS: P.O. BOX 4346
PHONE NUMBER: 535-1711
(Street)
SPOKANE, WASHINGTON 99202
(City/State)
(Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER
OF UNITS X EACH
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 PIING (5 OR MORE. EACH:)
REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP)
REFRIG 101-500M BTU
REFRIG 501-1,000M BTU
REFRIG 1,001-1,750M BTU
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_
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
f
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 =
/2.o 0
NOTE: MINIMU PERMIT FEE I8 $35.00
SIGNATURE��'2-
SUBTOTAL
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675