1992, 03-16 Permit App: 92001560 Heat Pump3Q5dU- X 65 a a
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D- 1560
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•-Ce/q-a MECHANICAL PERMIT APPLICATION FORM
Information Worksheets Y
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JOB STREET ADDRESS:+`� - 2S y y
CITY/STATE/ZIP. SH IFLCTD ? W s -a 6 PARCEL NUMBER:
OWNER: Ear- J'// /Fee TT PHONE NUMBER: 7.27 9//'
MAILING ADDRESS: -f,4"r'�
(Street) (City/State) (Zip)
CONTRACTOR' Bnnnnr Furnnre F Purl Tnr.LICENSE NUMBER: BANNEFF378NT
CONTACT: RUSS LUNDE PHONE NUMBER: 515-1711
MAILING ADDRESS: P.O. Box 4346 Spokane, WA. 99202
(Street) (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WPODSTOVEJTttgilT !Mar
GAS WATER HEATER
dA.CO )TPf4E0 2f00;000i ,MTIA
GAS EQUIPMENT+100,000 BTU DUCTWORK)
GAS PIPING (EAOUTLET)
BOILER/REFRIG 1-100M BTU
BOILER/REFIO 01` 50'0„M WV.,.,;
BOILER/REFRIG 501-1,000M BTU
BOILER/R.EFT7"IG 7 000Yl{7&&ff,&TL
BOILER/REFRIG +1,750M BTU
HEAT PUMP &'A)R boRDf toh1EF! 6"3 TOIJSrr. .x
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT PUMP & AI_a CONDITT NEpiS $0 YOAS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT PUMP; IECONaingglaa, 0 T„O(J( $x,`'- d..
VENTILATING FANS
EVAPORATI'EOOLEF-
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)-
TYPE II Hatifi ?ga;y ages A n""x z
CLOTHES DRYER
RANGE " •`'
GAS LOG
MISCELLANEOUS 09.01%.0..,,ElISp.tisEWPAhe::a1
UNLISTED GAS APPLIANCE <400.000 BTU
ULINSTEd GAS APPLIANCE"• 00 000 BTU.,"
USED APPLIANCE <400,000 BTU
USED APPLIATJC'74000•'i'U,r-
AIR HANDLER <10,000 CFM
AIR HANDLEFi:310,OOd Cly( y; a,.
NOTE: 'MINIMUM PERMIT FEE IS $35.00
SIGNATURE
(zip)
NUMBER
OF UNITS
XEACH
UNIT
=AMOUNT
x 10.00 =
x 25.00 =
x 10.00 =
x12.00 =
x 15.00 =
x 1.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x12.00 =
x 20.00 =
x 25.00 =
X 35.00 =
x60.00 =
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 =
/?.0n
SUBTOTAL
$ /y. o.
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
_$ .3TP°
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokarie, WA 99260 (509) 456-3675