1992, 09-16 Permit App 92007701 Wtr Htr, Htg EquipJOB STREET ADDRESS:
CITY/STATE/ZIP:
MECHANICAL PERMIT APPLICATION FORM
Informatioti Worksheet
cpo! G PARCEL NUMBER:
Cj�rl,Za�
oo5
OWNER: /jwGil 7/f-a "..Of o. PHONE NUMBER: a! Z. 6
MAILING ADDRESS: _re4- 4.
(Street) (City/State)
CONTRACTOR: Rannpr FiirnarP Fc Fii 1 Tnc-,LICNSE NUMBER: BANNEFF378NT
CONTACT: RUSS LUNDE
MAILING ADDRESS: P•0-
Box 4346
PHONE NUMBER: 535-1711
Spokane, WA. 99202
(Zip)
DESCRIPTION
(Street)
(City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
W OO D S T O V E/ 1 N S E RT>
GAS S WATER HEATER
GAEQUi:P ENT 00000 (U {NC1:UD.
GAS EQUIPMENT +100,000 BTU DUCTWORK)
GAS PIPING (EA.OUTLET)
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG 1O1 ............;
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG :10001•
1,750M BTU;;;;
BOILER/REFRIG +1,750M BTU
HEAT PUMP & AIR CONDITiONER`O-3 TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT PUMP & AIR CONDITIONED 15 30 TONS
HEAT PUMP & CONDITIONER 30-50 TONS
HEAT. PUMP & AiR CONDITIONER;:+50 TONS`>
VENTILATING FANS
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 BTI�
USED APPLIANCE <400,000 BTU
USED APPLIANCE >40(X000 E
AIR HANDLER <10,000 CFM
AIR HANDLER>10,000'.GFM,'..
NOTE: MINIMUM PERMIT FEE 1S $35.00
SIGNATURE
(gip)
NUMBER _
OF UNITS
X EACH
UNIT
= AMOUNT
x10.00 =
x 25.00 = 5
x10.00 =
x 12.00 _
x 15.00 =
x 1.00 =
x 12.00 =
x20.00 =
x 25.00 =
x35.00=
x 60.00 =
x12.00 =
x 20.00 =
x25.00 =
x 35.00
x 60.00 =
x 10.00 =
x10.00 =
x50.00
x 10.00 =
x 10.00 =
x10.00 =
x 10.00 =
x 10.00 =
x50.00=
x100.00 =
x 50.00 =
x100.00 =
x 12.00 =
/O-00
1
/�-6z_o:o
2.
Zoo
x 15.00 =
SUBTOTAL .
$ 2. Y °O.
PLUS: PROCESSING FEE .
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
_ $ /? O°
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675