1991, 09-17 Permit App: 91005890 Furnace, PipingMECHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: 'Fry-Mt-Yr/4 ��^)
CITY/STATE/ZIP: ?9Ar L PARCEL NUMBER:
OWNER: Con -.ea L Se -se- PHONE NUMBER: 9 i L i/ 0 y
MAILING ADDRESS:
(Street) (City/State)
CONTRACTOR: Banner Furnace & Fuel, Inc LICENSE NUMBER: BANNEFF378NT
CONTACT RUSS LUNDE PHONE NUMBER: 535-1711
MAILING ADDRESS: F.O. Box 4346
Spokane, WA.
(Zip)
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:1 ofL500M:BTU
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG 1;0001.-1;750M BTU :,
BOILER/REFRIG +1,750M BTU
HEAT PUMP &'AIR'CONDITIONER 073 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 ->400,000
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
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x 25.00 =
x 10.00 =
x12.00 =
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 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 =
/A o;o
f
/. • .•
SUBTOTAL
$ a 0'
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
_ $ ii °i'
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675