1989, 08-07 Permit App: 89002655 Furnace, Piping MECHANICAL PERMIT APPLICATION FORM
Inferma",ion Worksheet
JOBSTREET ADDRESS: 0 1 1 0 5 C t �3 w2.., Ko
/
11111RTATE/ZIP: erg p?2-CS- PARCEL NUMBER:
OWNER: (-0-191e-LeS r3 lZ ea- K.i e26 CPHONE NUMBER: 9 2.4 7 E K 3
MAILING ADDRESS: !J 1 "7 a S W l[..13 u.2. )C- S/'o ki9-,f/r__ C d/ ? 92,0 G
(Street) (City/State) (Zip)
CONTRACTOR: BANNER FURNACE $ 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 x 12. 00 =
HEATING EQUIPMENT +100; 000 BTU 1 x 15. 00 = / 2C.-(1-0
GAS PIPING (1 - 4 OUTLETS) / x 4 . 00 = 4i,. 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 _ _ x 12. 00 =
HEAT PUMP & AIR CONDITIONER 3-15 TONS _ x 20.00 =
HEAT PUMP & AIR CONDITIONER 15-30 TONSx 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 =
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 $ /7, 0e
PLUS: PROCESSING FEE + $ 25. 00
EQUALS: TOTAL PERMIT
NOTE: MINIMUM EF
PERMIT F ,IS $35.00 FEE DUE _ $ O
SIGNATURE c C ?*11c?/,/ Ly 6a
Spokane County Department of Building and Safety 7
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675