1992, 07-14 Permit App: 92005234 Heat Pumpuc�2a 4. (o5ao 4'V -G12, 523
v�
MECHANICAL 'ERMITAPPLICATION FORM
Information Worksheet X21
-JOB STREET ADDRESS:
CITY/STATE/ZIP: C.o Gt-utZ .f/� PARCEL NUMBER:
owHrRdedQ MrL7 400e 4culr'e_ PHONE NUMBER: rze 3LO Z,
MAILING
(Street) (City/State) (zip)
CONTRACTOR: Ra n r Furnace & File] Inc 110ENSE NUMBER: BANNEFF378NT
CONTACT: RUSS LUNDE PHONE NUMBER: 535_1711
MAILING ADDRESS: F.O. Box 4346 Spokane, WA. 99202
(Street) (City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVEIINSERT ,
GAS WATER HEATER
GAS EQUIPMENT Y160,600 EITU (INCLUDES
GAS EQUIPMENT+100,000 BTU DUCTWORK)
GAS PIPING (EA OUTLET)
BOILER/REFRIG 1-100M BTU
EfOILER/REFRIG 161-506M BTU
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG :1,0001-1,760WEITU
BOILER/REFRIG +1,750M BTU
HEAT PUMP & AIR CONDITIONER 6-3 TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT PUMP & AIR CONOITIONER 15-30 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT PUMP & AIR' CONDITIONER x50 TONS
VENTILATING FANS
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE II HOOD
CLOTHES DRYER
RANGE
GAS LOG
MISCELLANEOUS (NOT COVERED ELSEWHERE
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED GAS' APPLIANCE >460,000 BTU
USED APPLIANCE <400,000 BTU
USED APPLIANCE >400,000 BTU
AIR HANDLER <10,000 CFM
AIR HANDLER>10,000 CFM
NOTE: MINIMUM PERMIT FEE IS $35.00
NUMBER
OFUNITS
XEACH
UNIT
=AMOUNT
X 10.00 =
x 25.00 =
X 10.00 =
x 12.00 =
x 15.00 =
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 =
X 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 =
2.N
SUBTOTAL
$
PLUS: PROCESSING FEE
+$ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
=$ �7w
SIGNATURE / -
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675