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1989, 07-19 Permit App 89002300 Furnace
MECHANICAL PERMIT APPLICATION FORM / Information Worksheet JOB STREET ADDRESS: (: F0 0 3 L4 c - L( d CITY/STATE/ZIP: SF0 WA't7 /:Z-,ARCEL NUMBER: OWNER: ?-.\0:9=.. yv fPra72- PHONE NUMBER: 7.2 G G -12-p MAILING ADDRESS:_ ,,sf}-y.1� (Street) CONTRACTOR: BANNER FURNACE $ FUEL CONTACT: RUSS LUNDE (City/State) (Zip) LICENSE NUMBER: BANNLFF378NI' PHONE NUMBER: 535-1711 MAILING ADDRESS: F.O. BOX 4346 SPOKANE, WASHINGTON 99202 (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE DESCRIPTION OF F UNITS I X EACH 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 PII;ING (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 _ HEAT 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 C (NOT OVERED 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 - _ _ _ _ _ _ _ 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 = X2_0 u I _ SUBTOTAL $ 00 PLUS: PROCESSING FEEI+ $ 25.00 (EQUALS: TOTAL PERMIT NOTE: MINI2 UM PERMIT FEE 1"35.00 FEE DUE _ $ 37-013 SIGNATURE £ 7/ Spokane County Dep rtment of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675