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1991, 10-18 Permit App: 91006956 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM Information Worksheet / JOB STREET ADDRESS: - `t'" t"l'r7O % /1-1/4-1, CITY/STATE/ZIP: Q 927 PARCEL NUMBER: OWNER: IS .4J( cre6 12yA'7-7 PHONE NUMBER: ?26. 77 9 9 MAILING ADDRESS: .fiq-y'-` (Street) (City/State) CONTRACTOR: Banner Furnare_&_Euel , Inc LICENSE NUMBER: BANNEFF378NT CONTACT: RUSS LUNDE MAILING ADDRESS: F.O. Box 4346 PHONE NUMBER: 535-1711 (Zip) Spokane, WA. 99202 (Street) (City/State) MECHANICAL WORKSHEET/FEE SCHEDULE DESCRIPTION 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 501-1,000M BTU BOILER!REFRIG..1'0001-.1Jaw 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>400,0 00 BTU USED APPLIANCE <400,000 BTU USED APPLIANCE>400,000 BTU AIR HANDLER <10,000 CFM AIR HANDLER );10,000 NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE (Zip) NUMBER OF UNITS X EACH . UNIT = AMOUNT x 10.00 = x 25.00 = x 10.00 = x 12.00 = x15.00 = 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 = ( 7 a, o -o L /f 0° .2- Z_ o ' 2a, e. SUBTOTAL $ y7.a* + $ 25.00 PLUS: PROCESSING FEE EQUALS: TOTAL PERMIT FEE DUE =$ 7 2 p0 Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675