1990, 08-09 Permit App: 90003843 AC MECHANICAL PERMIT APPLICATION FORM
Infor atjon Worksheet
JOB STREET ADDRESS: �� / 3 c& 2_ 0 u 19--L-C._6/kJ AA r
_*
CITY/STATE/ZIP: „S74} -fr"l PARCEL NUMBER:
OWNER: V '44 r .-7'^' O 7--4 PHONE NUMBER: 7A C" ti f i
MAILING ADDRESS: _ 1I€ ,S"(..,►).‘ 1.-Ji 9' ? 2-/ 6
(Street) (City/State) (Zip)
CONTRACTOR: BANNED FURNACE E FUEL LICENSE NUMBER: BANNEFF378NT
CONTACT: RUSS LUNDE PHONE NUMBER: 535-1711
MAILING ADDRESS: P.O. BOX 4346 SPOKANE, WASHINGTON 99202
(Street) (City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
1 NUMBER X EACH
DESCRIPTION OF UNITS UNIT = AMOUNT
DUCTWORK SYSTEM x$10. 00 =
WOODSTOVE/INSERT x 25. 00 =
GAS WATER HEATER x 10.00 =
HEATING EQUIPMENT <100,000 BTU x 12.00 =
HEATING EQUIPMENT +100;000 BTU x 15. 00 =
GAS PIPING (1 - 4 OUTLETS) x 4 . 00 =
GAS PIING (5 OR MORE. EACH: ) x 1. 00 =
REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP) x 12. 00 =
REFRIG 101-500M BTU x 20. 00 =
REFRIG 501-1, 000M BTU x 25.00 =
REFRIG 1, 001-1,750M BTU x 35. 00 =
REFRIG +1,750M BTU x 60.00 =
HEAT PUMP & AIR CONDITIONER 0-3 TONS _ _ 1 x 12.00 = I 2_____o .
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 -7 x 60. 00 =
VENTILATING FANSx 10.00 =
EVAPORATIVE COOLERS 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 x 10. 00 =
MISCELLANEOUS (NOT COVERED ELSEWHERE)_ _ x 10.00 =
UNLISTED GAS APPLIANCE <400,000 BTU _ _ x 50.00 =
UNLISTED GAS APPLIANCE >400,000 BTU_ _ _ x100.00 =
USED APPLIANCE <400, 000 BTU x 50.00 =
USED APPLIANCE >400, 000 BTU x100. 00 =
AIR HANDLER <10, 000 CFM x 12. 00 =
AIR HANDLER >10, 000 CFM x 15.00 =
SUBTOTAL $ /2 . 04
PLUS: PROCESSING FEE + $ 25. 00
EQUALS: TOTAL PERMIT
NOTE: MINIMUM ERMIT FEEESIS $35.00 FEE DUE = $ 3 7. • '
SIGNATURE C 4"..a1/ "
S kane County Department of Building and Safety
West 1 03 Broadway Avenue Spokane, WA 99260 (509) 456-3675