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1992, 07-14 Permit App: 92005218 Heat PumpMECHANICAL PERMIT APPLICATION FORM f,2- 5211 Information Worksheet l./-11 JOB STREET ADDRESS: -Th 'S%tyS /d/ditl.e- C.7" CITY/STATE/ZIP: 97637 PARCEL NUMBER: OWNER: / - Oo.terN`/ fdir/itc.r PHONE NUMBER: Ire 9,L V Y 6 97 MAILING ADDRESS: (Street) (City/State) CONTRACTOR: Banner Furnace F. Fool , Tnri.LICENSE NUMBER: BANNEFF378NT CONTACT: RUSS LUNDE MAILING ADDRESS: F.O. Box 4346 PHONE NUMBER: 535-1711 I 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 9TU,(INCLUDES GAS EQUIPMENT 60,060 BTU DUCTWORK) GAS PIPING (EA OUTLET) ' BOILER/REFRIG 1-100M BTU BOILER/REFRIG 10f-500M:BT.U. BOILER/REFRIG 501-1,000M BTU BOILER/REFRIG (,0001=1;750M`BTU BOILER/REFRIG +1,750M BTU HEAT PUMP,& AIR CONDITIONER 0-3 TONS HEAT PUMP & AIR CONDITIONER 3-15 TONS HEATPUPVIP &AIR CONDITIONER 15-30ETONS HEAT PUMP & AIR CONDITIONER 30r50 TONS HEAT PUMP & AIRtONDITIONER +50 TONS VENTILATING FANS EVAPORATIVE COOLERS: ` Hi: 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 x10.00 x 12.00 x 15.00 x 1.00 x 12.00 x 20.00 x25.00 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 SUBTOTAL $ / z. n PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE =$ 37-.0 Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675