1990, 09-07 Permit App: 90004437 Mechanical Fixtures MECHANICAL, PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: JE / 4 0// G./,&•L1 j"G,ec� ,j 67J _ 0/da
CITY/STATE/ZIP: J/to'n PARCEL NUMBER:
OWNER: AC.L�� piety G 4.4-ipe42 PHONE NUMBER: ,-2- 4, S-2. -Y
MAILING ADDRESS: Sffr17,0.--' $Po kA.-,J,‹ Wf}- j 7,Z1‘
(Street) (City/State) (Zip)
CONTRACTOR: BANNER FURNACE F, 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
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 i' x 12. 00 = 1 D. o .
HEATING EQUIPMENT +100;000 BTU x 15. 00 =
GAS PIPING (1 - 4 OUTLETS) I x 4 . 00 = i{_ o
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 _ _ 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 --7,
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 =
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 $ ' c.o v o
PLUS: PROCESSING FEE + $ 25. 00
EQUALS: TOTAL PERMIT
NOTE: MINIMU PERMIT E IS $35.00 FEE DUE = $ Lr (� a O
SIGNATURE i r
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675