1993,08-26 Permit App: 92005233 Heat Pump S\TI''D ' \o\`' �� CA2,�a3�
ovc� Q� MECHANICAL>PERMIT APPLICATION FORM
`�Q . Information Worksheet (p21
,JOB STREET ADDRESS:
CITY/STATE/ZIP: 9 z PARCEL NUMBER:
OWNER: 'Z tc-L. /'4-`" . PHONE NUMBER: 92 4 VI' 7 t°'
MAILING ADDRESS: ..f,4•••••6C.
(Street) (City/State) (Zip)
CONTRACTOR: Banner Furnace & Fuel , Inc.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 =
woODSTOVE/INSERT x 25.00 =
GAS WATER HEATER x 10.00 =
GAS'EQUIPMENT:<100 000 TU (INCLUDES . .., ,: x 12.00
GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 =
, GAS PIPING (EA OUTLET) x 1.00 = _J
BOILER/REFRIG 1-100M BTU x 12.00 =
EOILER/REFRIG 101.:500M R1 U'. x 20.00 =
BOILER/REFRIG 501-1,000M BTU x 25.00 =
. .............................................................................................................................
BOILER/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 = /4 -�
HEAT PUMP & AIR CONDITIONER 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 FANS x 10.00 =
EVAPORATIVE C:OOLERS:.:. x 10.00 =
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) x 50.00 =
TYPE II HOOD x 10.00 =
CLOTHES DRYER x 10.00 =
RANGE x 10.00 =
GAS LOG x10.00 =
MISCELLANEOUS (NOTCOVERED ELSEWHERE:: x 10.00 =
UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 =
ULINSTED GAS APPLIANCE>400,000 BTU: x100.00 =
USED APPLIANCE<400,000 BTU x 50.00 =
USED APPLIANCE>400,000'. TU x100.00 =
AIR HANDLER <10,000 CFM x 12.00 =
AIR HANDLER>10,000 CFM x 15.00 =
SUBTOTAL $ /2-i3
PLUS: PROCESSING FEE +$ 25.00
NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT
FEE DUE = g 37-0�
SIGNATURE
ff Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675