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