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1992, 11-12 Permit App 92010032 Gas Range-Voidto ��+" ME- .1ANICAL ERMIT APrLICATION . JRM 1 1. - 7 $ 3 Information Worksheet a`ot JOB STREET ADDRESS: - 41. ' 7: ..5- Z/"t7i��. CITY/STATE/ZIP: LRZEDJ Q PARCEL NUMBER: OWNER: 1�'4�``- ' -�'L- PHONE NUMBER: 92 `i93 f c, MAILING ADDRESS: Ja''"e.._ (City/State) ' (Zip) CONTRACTOR: Bann Pr Furnac F� Fu 1 Tnc LICENSE NUMBER: BANNEFF378NT CONTACT: RUSS LUNDE PHONE NUMBER: 535-1711 (Street) MAILING ADDRESS: P.O. Box 4346 Spokane, WA. 99202 DESCRIPTION (Street) (City/State) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH OF UNITS UNIT ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) WOODSTOVE/INSERT GAS WATER HEATER GAS EQUIPMENT <100,000 BTU (INCLUDES GAS EQUIPMENT +100,000 BTU DUCTWORK) GAS PIPING (FA OUTLET) BOILER/REFRIG 1-100M BTU BOILER/REFRIG 101_500M>BTU BOILER/REFRIG 501-1,000M BTU BOILER/REFRIG"1,0001'1 750M'BTU BOILERIREFRIG +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 (NOT COVERED ELSEWHERE UNLISTED GAS APPLIANCE <400,000 BTU ULINSTED 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 PERMIT FEE IS $35.00 SIGNATURE SUBTOTAL x 10.00 = x 25.00 = x 10.00 = x 12.00 = x 15.00 = x 1.00 = x12.00 = x 20.00 = x 25.00 = x35.00 = 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 = (Zip) = AMOUNT b-d 0 $ /o oo PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE 3-r v° Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675