1991, 12-09 Permit App: 91008487 Heat Pump gal
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MECHANICAL PERMIT-APPLICATION FORM °, I - 8 (181
1CN4 kE U� Informetibn Worksheet o 7Liac,
JOB STREET ADDRESS: l !!
CITY/STATE/ZIP: 9 924 Z--' PARCEL NUMBER:
OWNER: L y L( ..!'/,1f'',Tf PHONE NUMBER: 92-Z Q �--3_2
MAILING ADDRESS:
(Street) (City/State) (Zip)
CONTRACTOR: Rann r Furnace & Fuel, Ino,LICENSE NUMBER: BANNEFF378NT
CONTACT: RUSS LUNDE PHONE NUMBER: 535-1711
MAILING ADDRESS: P.O. Box 4346 Spokane, WA. 99202
(Street) • • (City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
DESCRIPTION OF UNITS UNIT = AMOUNT
ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 =
WOODSTOVEIINSERT. x 25.00 -
GAS WATER HEATER x 10.00 =
GAS EQUIPMENT<1 oo,o00 BTl!(INCLUDES x 12.00 =
GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 =
GAS,PIPING (EA OUTLET) x 1.00 =
BOILER/REFRIG 1-100M BTU x 12.00 =
BOILER/REFRIG .1;01 S.0:0M3.0Cl x 20.00 =
BOILER/REFRIG 501-1,000M BTU x 25.00 =
BOILBR/REFRIG 1,0001 -1,750M BTU <; x 35.00 =
BOILER/REFRIG +1,750M BTU x 60.00 =
HEAT PUMP & AIR CONDITIONER 0-3 TONS ( - x 12.00 = / Z.
HEAT PUMP & AIR CONDITIONER 3-15 TONS x 20.00 =
HEAT•PUMP &AIR CONDITIONER X15-80 TONS x 25.00 =
HEAT PUMP &AIR CONDITIONER 30-50 TONS x 35.00
HEAT PUMP &.AIR CONDITIONER }50 TONS x 60.00 =
VENTILATING FANS x 10.00 =
EVAPORATIVE COOLER$! ```"° '``"' x 10.00 =
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) x 50.00 =
TYPE II HOOD :;
:: x10.00 =
CLOTHES DRYER x 10.00 =
RANGE x 10.00 =
GAS LOG x 10.00 =
MISCELLANEOUS(NOTiCCVfb;tLSEWHERE x 10.00 =
UNLISTED GAS APPLIANCE 400,000 BTU x 50.00 =
ULINSTED.GAS APPLIANCEb8,000 BTU;.. x100.00 =
USED APPLIANCE<400,000 BTU x 50.00 =
USEDAPPLIANCE .40t 0(I!3 ICU x100.00 =
AIR HANDLER <10,000 CFM x 12.00 =-
AIR
AIR HANDLER>10,000`CFM x 15.00 =
SUBTOTAL $ /2 o
PLUS: PROCESSING FEE +$ 25.00
NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT
FEE DUE =$ 3709
SIGNATURE
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675