1992, 02-25 Permit App: 92001038 Mechanical Fixture0351)a-39(055 q
MECHANICAL PE(MIT APPLICATION FORM I a- I -03 Y
. / Information Worksheet ����
JOB STREET ADDRESS: : A. ''`f 6 /s f' ` J o N4 -c_17
CITY/STATE/ZIP: 9`%R/6 PARCEL NUMBER:
OWNER: C41,9,-R-"sO-.✓4; m/7'e° PHONE NUMBER: `i 2 s-3 z k-7
MAILING ADDRESS:
(Street) (City/State)
CONTRACTOR: BannenEurnace_&fuel . ine_,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, STU (INCLUDES
GAS EQUIPMENT+100,000 BTU DUCTWORK)
GAS PIPING (EA OUI LET)
BOILER/REFRIG 1-100M BTU
BOILERlREFRIG 101-500M BTU
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG1,0001-1.750M
BOILER/REFRIG +1,750M BTU •
HEAT PUMP & AIR CONDITIONER 04 TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT PUMP & AIR.CONDITIONER 15-30 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEATPUMP &.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 =
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
x10.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x100.00 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
/.Z c •
-
SUBTOTAL
$ /2, o.,
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
_$ 37-�°
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675