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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