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1991, 01-08 Permit App: 91000075 FurnaceMECHANICAL PERMIT APPLICATION FORM Information. Worksheet JOB STREET ADDRESS: /05' e / �0 f q CITY/STATE/ZIP: PARCEL NUMBER: PIz a R OWNER: tlj/'L w'4i'-s �" PHONE NUMBER: q 2- e, .iL/S MAILING ADDRESS - �- �- (Street) (City/state) (Zip) CONTRACTOR: BANNER FURNACE E 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 EAC "UNIT" DESCRIPTION I OFUUNITS I I = AMOUNT DUCTWORK SYSTEM_ _ WOODSTOVE/INSERT _ _ _ _ _ _ _ _ _ _ _ _ GAS WATER HEATERX _ HEATING EQUIPMENT <100,000 BTU _ _ _ _ HEATING EQUIPMENT +100,000 BTU _ _ _ _ _ GAS PIPING (1 - 4 OUTLETS) _ _ _ _ _ _ GAS PIVING (5 OR MORE. EACH:)_ _ _ _ _ _ REFRIG 1-100M 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_ O-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 FANS _ _ _ _ _ _ _ _ _ _ EVAPORATIVE COOLERS_ TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) TYPE II HOODX CLOTHES DRYER ______ _______ RANGE_ ------- - -- ---- GAS LOG ______ __________ MISCELLANEOUS (NOT COVERED EISEWHERE)_ 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$10.00 = X 25.00 = 10.00 - X 12.00 = x 15.00 = X 4.00 = x 1.00 = x 12.00 = x 20.00 = x 25.00 = x 35.00 = X 60.00 = x 12.00 = x 20.00 = x 25.00 = x 35.00 = x 60.00 = x 10.00 = X 10.00 = x 50.00 = 10.00 = x 10.00 = x 10.00 = x 10.00 = X 10.00 = x 50.00 - x100.00 = x 50.00 = x100.00 - x 12.00 = x 15.00 = �- �- SUBTOTAL$ z 0+ PLUS: PROCESSING FEE + $ 25.00 NOTE: MINIMUM�RMIT FEE IS $35.00 I FEE DUE STGNATURR _ L` Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675