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1990, 10-29 Permit App: 90005696 Furnace, PipingMECHANICAL PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: / oZ Rat. o / O ��- CITY/STATE/ZIP: PARCEL NUMBER: OWNER: EL U 13C PHONE NUMBER: n/".Z y J? 7 MAILING ADDRESS: SA"""�° 9 Z/ G (Street) Cit 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 I NUMBER I X EACH DESCRIPTION I OF UNITS I UNIT I = AMOUNT DUCTWORK SYSTEM _ _ _ WOODSTOVE/INSERT _ _ _ _ _ _ _ _ _ _ _ _ GAS WATER HEATER. _ _ _ _ _ HEATING EQUIPMENT <100,000 BTU _ _ _ _ _ HEATING EQUIPMENT +100;000 BTU _ _ _ _ _ GAS PIPING (1 - 4 OUTLETS) _ GAS PIING (5 OR MORE. EACH:)_ _ _ _ _ _ REFRIG 1 -LOOM BTU (NOT A/C OR HEAT PUMP) REFRIG 101-500M BTU _ REFRIG 501-1,000M BTU_ _ _ _ _ _ _ _ _ REFRIG 1,001-1,750M BTU_ _ _ _ __ _ _ _ REFRIG +1,750M BTU _ _ HEAT PUMP & AIR CONDITIONER 0-3 TONS _ HEAT PUMP & AIR CONDITIONER 3-15 TONS _ HEAT PUMP & AIR CONDITIONER 15-30 TONS _ HEAT PUMP & AIR CONDITIONER 30-50 TONS _ HEAT PUMP & AIR CONDITIONER +50 TONS_ _ VENTILATING FANSx _ EVAPORATIVE COOLERS TYPE I HOOD (PER 12' OR 12'_ PTN. OF HOOD) TYPE II HOODx CLOTHES DRYER _ _ _ _ _ _ _ _ _ _ _ _ _ _ RANGE � _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ GAS LOG _ _ _ _ _ MISCELLANEOUS (NOT COVD ELSEREEWHERE)_ _ UNLISTED GAS APPLIANCE <400,000 BTU_ _ _ UNLISTED GAS APPLIANCE >400,000 BTU_ _ USED APPLIANCE <400,000 BTU_ _ _ _ _ _ _ USED APPLIANCE >400,000 BTU_ _ _ _ _ _ _ AIR HANDLER <10,000 CFM _ _ _ _ _ _ _ AIR HANDLER >10,000 CFM _ _ _ _ _ _ _ _ x$10.00 = x 25.00 = X 10.00 = x 12.00 = x 15.00 = x 4.00 = x 1.00 = x 12.00 = x 20.00 = x 25.00 = x 35.00 = x 60.00 = x 12.00 = x 20.00 = x 25.00 = x 35.00 = x 60.00 = 10.00 = x 10.00 = x 50.00 = 10.00 = x 10.00 = x 10.00 = x 10.00 = x 10.00 = x 50.00 = x100.00 = x 50.00 = x100.00 = x 12.00 = x 15.00 = �- y om SUBTOTAL PLUS: PROCESSING FEE !+ $ NOTE: MINIMUM PERMIT FEE IS $35.00 FEE DUE SIGNATURE SpS okane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 ,(G e 25.00