1992, 05-21 Permit App: 92003595 Mechanical Fixtures 54`1
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f MECHANICAL PERMIT'APPLICATION FORM 35cI
Information Worksheet (�D
JOB STREET ADDRESS: _.I / o / /4L 1"1.-"7(.(
CITY/STATE/ZIP: 9 ? L1/‘ PARCEL NUMBER:
OWNER: /A 77 L.9"7vesr "J 6--- PHONE NUMBER: 72
MAILING ADDRESS:
(Street) (City/State) (Zip)
CONTRACTOR: Ranner Furnace & Fuel, Tnc.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 = / D
GAS EQUIPMENT<100,000 BTU(INCLUDES x 12.00 =
GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 = y�v
GAS PIPING (EA OUTLET) x 1.00 =
BOILER/REFRIG 1-100M BTU x 12.00 =
BOILER/REFRIG 101-500M BTU 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 =
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 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 =
ULINSTED 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_6. o
PLUS: PROCESSING FEE + $ 25.00
NOTE: MINIMUM PERMIT FEE IS $35.00 EQUALS: TOTAL PERMIT
FEE DUE = $
SIGNATURE
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675