1991, 06-13 Permit App: 91003315 Furnace, Water HtrY s e
MECHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: 0 sZ ( N 104-7--5 X -O
CITY/STATE/ZIP:
PARCEL NUMBER:
OWNER: /+L 13FZ •7 77Z-/,t/k- PHONE NUMBER:
MAILING ADDRESS:
CONTRACTOR:
(Street)
BANNER FURNACE £, FUEL
COVI';'\CI' : RUSS LUNDE
MAILING ADDRESS: P.O. BOX 4346
sq - fi b
(City/State) (Zip)
BANNEFF378NT
LICENSE NUMBER:
PHONE NUMBER: 535-1711
(Street)
SPOKANE, WASHINGTON 99202
(City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
DESCRIPTION OF UNITS UNIT = AMOUNT
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
(HEATING EQUIPMENT <100,000 BTU
BEATING EQUIPMENT +100;000 BTU
GAS PIPING (1 - 4 OUTLETS)
GAS PIING (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 0-3 TONS _
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT PUMP & AIR CONDITIONER 15-30 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
BEAT PUMP & AIR CONDITIONER +50 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_
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 IT FEE IS $35.00
SIGNATURE
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 =
SUBTOTAL
PLUS: PROCESSING FEE
EQUALS: TOTAL PERMIT
FEE DUE
+ $ 25.00
= $
Spokane- County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675