1991, 07-10 Permit App: 91004093 Furnace, Water Htr-5 O v
0_ 9 4s
/2-0+
MECHANICAL PERMIT .APPLICATION FORM
11 Information Worksheet
JOB STREET ADDRESS: f_,) p2 b-�-
CITY/STATE/ZIP:
OWNER:
oS CAE) C,
MAILING ADDRESS:
CONTRACTOR:
PARCEL NUMBER:
PHONE NUMBER:
(Street)
BANNER FURNACE $ FUEL
(TON'l'.\CT : RUSS LUNDE
MAILING ADDRESS: P.O. BOX 4346
9z� 8"rren.s
(City/State)
BANNEFF378NT
LICENSE NUMBER:
(Zip)
PHONE NUMBER: 535-1711
(Street)
SPOKANE, WASHINGTON 99202
(City/State)
(Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
OF UNITS UNIT
DESCRIPTION
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
BEATING EQUIPMENT <100,000 BTU
HEATING EQUIPMENT +100;000 BTU
GAS PIPING (1 - 4 OUTLETS)
GAS PIING (5 OR MORE. EACH:)
REFRIG 1-100M BTU (NOT A/C OR
REFRIG 101-500M BTU
HEAT PUMP)
REFRIG 501-1,000M BTU
REFRIG 1,001-1,750M BTU
REFRIG +1,750M BTU
HEAT PUMP &
BEAT PUMP &
HEAT PUMP &
BEAT PUMP &
HEAT PUMP &
VENTILATING
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
FANS
0-3 TONS _
3-15 TONS
15-30 TONS
30-50 TONS
+50 TONS
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12'
TYPE II HOOD
OR 12'
PTN. OF HOOD)
CLOTHES DRYER
RANGE
GAS LOG
MISCELLANEOUS (NOT COVERED ELSEWHERE)
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
NOTE: MINIMUM PE• : T FEE IS $35.00
Amp
SIGNATURE
Spoka
West 1303
SUBTOTAL
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
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
= AMOUNT
$
2 0
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $
County Department of Building and Safety
roadway Avenue Spokane, WA 99260 (509) 456-3675