1992, 01-07 Permit App: 92000094 Water HeaterMECHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: - 6-1S777- .3=4 S S ^' o c.-' a1 O I@. '_ / L j (
CITY/STATE/ZIP: � L 0 PARCEL NUMBER:
OWNER: G 4--d �- .0 PHONE NUMBER: 9 3 0
C1 2
MAILING ADDRESS:�i-
(Street) (City/State)
CONTRACTOR: Banner Furnace & Fuel, I c..LICENSE NUMBER: BANNEFF378NT
CONTACT: RUSS LUNDE
MAILING ADDRESS: P•0•
Box 4346
PHONE NUMBER: 535-1711
Spokane, WA.
(Zip)
99202
DESCRIPTION
(Street)
(City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVE/INSERI
GAS WATER HEATER
GAS EQUIPMENT ci00000 ITh (INCLUDES
GAS EQUIPMENT +100,000 BTU DUCTWORK)
GAS PIPING (EA OUTLET)
BOILER/REFRIG 1-100M BTU
BOILER/REFAIG 101,.;-500
BOILER/REFRIG 501-1,000M BTU
BOILER/FREFRIG ,0001.,;-1;i7 BTU:
BOILER/REFRIG +1,750M BTU
HEAT PUMP & AIR "CONDITIONER 04 TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT PUMP & AIR';CONDITIONEFI 15:-30 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT PUMP;:& AIR`CONDITION 1 +50 TONS
VENTILATING FANS
EVAPORATIVE COOLEF
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE II HOOD
CLOTHES DRYER
RANGE
GAS LOG
MISCELLANEOUS.(NOTCOVE ED 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 C
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
Spokane County DiVision of Buildings
West 1303 aroadway Avenue Spokane, WA 99260 (509) 456-3675
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x25.00 =
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 =
x20.00 =
x25.00 =
x 35.00 =
x 60.00 =
x10.00 =
x 10.00 =
x 50.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x10.00=
x 50.00 =
x100.00 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
(
j .D._ o
-;;'.
SUBTOTAL
$ / o, oa 1
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ .,3f-