1992, 06-17 Permit App: 92004394 Mechanical Fixtures MECHANICAL PErtMIIT APPLICATION FORM
Information Worksheet �� I
JOB STREET ADDRESS: .40.
CITY/STATE/ZIP: 9 Z/ y PARCEL NUMBER:
OWNER: fr'4 I k�'L / JJ PHONE NUMBER: j 2 Y 0 7 2- Y
MAILING ADDRESS: �A
(Street) (City/State) (Zip)
CONTRACTOR: Ranner F»rnace & Fue_l, 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 =
x 25.00 =
GAS WATER HEATER x 10.00 =
GAS EQUIPMENT<100,0001 TU(INCLUDES ( x 12.00 = J t: '. o+
GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 =
GAS PIPING (EA.OUTLET) x 1.00 =
BOILER/REFRIG 1-100M BTU x 12.00 =
. . .. . .............. ................................................................................................................
BOILER/REFRIG''101 500M ETU 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=0 TONS x 12.00 =
HEAT PUMP & AIR CONDITIONER 3-15 TONSx 20.00 =
.. ... . ................................................................................................................
HEAT..PUMP &AIR CONDITIONER 15 30<TONS x 25.00 =
HEAT PUMP &AIR CONDITIONER 30-50 TONS x 35.00 =
HEAT PUMP &AI.R 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
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:>400000 BTU x100.00 =
USED APPLIANCE<400,000 BTU x 50.00 =
USED APPLIANCE>400,0001BBTU x100.00=
AIR HANDLER <10,000 CFM x 12.00 =
AIR HANDLER>10,000 CFM x 15.00 =
SUBTOTAL $ t 1
PLUS: PROCESSING FEE +$ 25.00
NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT
FEE DUE _$ 37- Q°
SIGNATURE
Spokane County Diviaioli of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675