1990, 09-26 Permit App: 90004922 Furnace r MECHANICAL PERMIT APPLICATION FORM ¢ )
Information Worksheet CP P I
JOB STREET ADDRESS: / -i N WA L.id t --r
CITY/STATE/ZIP: S t"4-7'`1(E PARCEL NUMBER: / Y -J7('1
C-ir
OWNER: G:L.E,d n1 /1: l06: 1"--r PHONE NUMBER: 9a140. .S-C11
MAILING ADDRESS: Z14---P-t -- 99Le.)$�
(Street) Cit L$tate) (Zip)
CONTRACTOR: BANNER FURNACE f FUEL LICENSE NUMBER: BANNEFF378NT
CONTACT: RUSS LUNDE PHONE NUMBER: 55-1711
MAILING ADDRESS: P.O. BOX 4346 SPOKANE, WASHINGTQN 99202
(Street) (City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER K 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 = / 2-az
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 BTUj x 20.00
REFRIG 501-1,000M BTU x 25.00 =
REFRIG 1,001-1,750M BTU1 x 35.00
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 ' 7._ 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 =
UNLISTED GAS APPLIANCE >400,000 BTU x100.00 =
USED APPLIANCE <400,000 BTU_ '.. _ - _ _ X 50.00 =
USED APPLIANCE >400,000 BTUL _ x100.00 =
AIR HANDLER <10,000 CFM x 12.00 =
AIR HANDLER >10,000 CFM X 15.00 =
SUBTOTAL $ /2_, 0
PLUS: PROCESSING FEE + $ 25. 00
EQUALS: TOTAL PERMIT
NOTE: MINIMUM PERMIT PE IS $35.00 FEE DUE = $ 31- 0Q
SIGNATURE c r^
S okane County Department of Building and Safety
West 1 03 Broadway Avenue Spokane, WA 99260 (509) 456-3676