1991, 04-17 Permit App: 91001887 Water Heater MECHANICAL PERMIT 1PPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: '7 3/5- /z t/
CITY/STATE/ZIP: PARCEL NUMBER:
OWNER: C i4,4 (.4 ' PILL PHONE NUMBER: q.2 G / 0 7-J
MAILING ADDRESS:
(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 = /a . 0
HEATING EQUIPMENT <100,000 BTU x 12. 00 =
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 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 _ 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 $ j a 6
PLUS: PROCESSING FEE + $ 25. 00
EQUALS: TOTAL PERMIT-
NOTE: MINIMUM PERM T FEE IS $35.00 FEE DUE = $ 3: . �
SIGNATURE
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Spokane ounty Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675