1992, 11-12 Permit App: 92010030 Mechanical Fixtures MECHANICAL PERMIT APPLICATION FORM c14Q-1 DD3
information Worksheet �
JOB STREET ADDRESS: -1J1 Q ��� �'I Ll �� ' a(`c s
CITY/STATE/ZIP: JPoKt,r) ( f,1A PARCEL NUMBER:
OWNER: fleinnj 6-0dE ' PHONE NUMBER:
MAILING ADDRESS: ('V 1'01" IJ cc.X/1Lk+ / �po � �,� � iA 9 9 0(19
(Street) (City/State) (Zip)
CONTRACTOR: .Banner Furnace Ft FuelInc..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 = j 0,00
GAS EQUIPMENT<100,000 STU (INCLUDESx 12.00 =
GAS EQUIPMENT +100,000 BTU DUCTWORK) x 15.00 = /5,
GAS PIPINC (EA OUTLET) I x 1.00 = o?_
BOILER/REFRIG 1-100M BTU x 12.00 =
BOILER/REFRIG 101-500M;;STU 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 =
AIR CONDITIONER 0--3 TONS J x 12.00 = fa 03
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
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 $ 3`( ,OCA
PLUS: PROCESSING FEE + $ 25.00
NOTE: MINIMUM PERMIT FEE IS $35.00 EQUALS: TOTAL PERMIT
`, FEE DUE =- $
SIGNATURE C. -LA., lLIZ l'��.,L��. rpt
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675