1990, 02-28 Permit App: 90000682 Furnace, Piping MEUHANIUAL Pitwili APPLIUATIUN FURM
Information Worksheet
JOB STREET AbbRESS: 50 5 L-i TA g (
CITY/STATE/ZIP: ,f'fh- lit _ PARCEL NUMBER:
OWNER: Yui- b-i..1 ; " S (I AJ PHONE NUMBER: , Y 8-°F ''
MAILING 4ADD1tES5 S S v S Le r,4 X,p .Sr°0 tr,9 G-.4-
(Street) (City/State) (Zip)
CONTRACTOR: BANNER FURNACE 4 tun, LICENSE NUMBER: BANNEFF378NT
CONTACT: tU§8 LOOMOE PHONE NUMBER: 535-1711
MAILING ADDRESS: , P.O. $0X 4346 SPOKANE, WASHINGTON 9920'
(Street) (City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
DESCRIPTION OF UNITS UNIT = AMOUNT
DUCTWOR1t SYSTEM x$10.00 =
WOODSTOVE/INSERT x 25. 00 =
GAS WATER HEATER x 10.00 =
HEATING EQUIPMENT<100,000 BTU t x 12.00 = ) 2, 00
HEATING EQUIPMENT +101000 fTU x 15. 00 =
GAS PIPING (1 - 4 OUTLETS) r x 4 . 00 = zi-o ti
GAS PIING (5 OR MORE. EACH: ) _ _ x 1.00 =
REFRIG 1-100MB (NOT A/c OR HEAT PUMP) x 12. 00 =
REFRIG 11-500M BTU x 20. 00
REFRIG 1,001r1,' SOMT _BTU X 35. 00 = -
REFRIG 501-1000M REFRIG +1,750M BTU _ _ x 60.00 =
HEAT PUMP & AIR CONDITIONER 0-3 TONS _ _ X 12.00 =
HEAT PUMP & AIR CONDIT/oNER 3-15 TONS _ x 20. 00 =
HEAT PUMP & AIR CONDITIONER 15-30 TONS _ x 25. 00 =
HEAT PUMP & AIR CONDITIONER 30-50 TONS _ x 35. 00 =
HEAT PUMP & AIR CONDITIONER +50 TONS x 60.00 =
VENTILATING PANS ; - - x 10. 00 =
EVAPORA'T'IVE COOLERS x 10. 00 =
TYPE I HOOD (PER. IV V OR 12 1-PTN OF-H565) x 50.00 =
TYPE II HOOD ,w_ ,Ir .. r , x 10.00 =
CLOTHES DRYER: _ _ x 10. 00 =
RANGE "- f - - _ x 10.00 =
GAS 'ha
v,. �.. °..,. .� :., ... .;. .. ... ... _ _ x 10. 00 =
MISCELLANEOU (HOiT COVERED ELSEWHERE)- - x 10.00 =
UNLISTED GAS 'APPLIANCE :<400,006 BTU x 50.00 =
UNLISTED GAS APPLIANCE. >400,000 Wt't1- - - x100.00 =
USED APPLIANCE <400,000 1 ' . - - -
.� Mak *. .... ... x 50.00 =
USED APPLIANCE >400,006 BTU_ _ _ . _ _ x100. 00 =
AIR HANDLER <10,000 cPM AIR HANDLER >10,000 CPM - �` x 12. 00 =
x 15.00 =
SUBTOTAL $ / 4 00
PLUS: PROCESSING FEE + $ 25. 00
EQUALS: TOTAL PERMIT /
NOTE: MINIMt1M PERM TPEE Is $35.00 PEE DUE = $ 4 / o a
SIGNATURE Arn7`-�'" �
S okan ; County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675