1992, 07-27 Permit App: 92005718 Water Heater, PipinguSk5a, ot-koL1 15
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�� I MECHANICAL PERMIT APPLICATION FORM
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�,,A4/'I t4 Information Worksheet
JOB STREET ADDRESS: - 7:: 7/ 2 P a 2- € /YIA-,r r.✓6 GC.
CITY/STATE/ZIP: PARCEL NUMBER:
OWNER: X e.r ✓a4
7'G ri ed rr
9? 5�
'733
PHONE NUMBER: C Z S' 7 -o o
MAILING ADDRESS:
(Street) (City/State)
CONTRACTOR: Banner Furnace & Fuel , Tnr LICENSE NUMBER: BANNEFF378NT
CONTACT: RUSS LUNDE
MAILING ADDRESS: P.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 OUTLE
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 A 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 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 "
SIGNATURE
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x 25.00 =
x 10.00 =
x 12.00 =
x 15.00 =
x 1.00 =
x 12.00 =
x20.00 =
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 =
/
j a. o-.
/ 0 •
SUBTOTAL
$ / /. a •
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
4, 'ii.,' 'FEE DUE
= $ 34-o a
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675