1992, 06-26 Permit Application: 92004532 Heat Pump & A/C/'2h(,
MECHANICAL PERMIT APPLICATION FORM�•� /f
Information Worksheet
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JOB STREET ADDRESS: "Q/ k/ 4 Q
CITY/STATE/ZIP: 5r9 rQ n.c., (,J, s PARCEL NUMBER:
OWNER: tC/it rJ )1$ vo /d PHONE NUMBER: '102r - 669/
MAILING ADDRESS:
(Street) (City /State) (Zip)
CONTRACTOR: AIRE VALLEY HEATING & cooling LICENSE NUMBER: AIREVHI1410H
PHONE NUMBER: 924 -0018
MAILING ADDRESS:
DESCRIPTION
N. 521 Ella Rd. pokane, WA 99212
(Street) (City /State)
MECHANICAL WORK
ELECTRIC /DUCTWORK (SEPARATE SYSTEMS)
WOOD ,.. E/INS;wRT` t r ;'..::.:.
GAS WATER HEATER
GAS EQUIPMENT;'IOO,OCO BT .(INCLUDES'
GAS EQUIPMENT +100,000 BTU DUCTWORK)
GAS PIPING ,(EA OUTLET)
BOILER/REFRIG 1 -100M BTU
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BOILER/REFRIG 1ni: ,5nn11�(
BOILER/REFRIG 501- 1,000M BTU
BOILER/REFRIG +1,750M BTU
HEAT PUMP &.AIIT oNDI<I'IONER :Toff
HEAT PUMP & AIR CONDITIONER 3 -15 TONS
HEAT PUMP' AIF1:C(QNDiTIONER` iS.:< t0NS
HEAT PUMP & AIR CONDITIONER 30 -50 TONS
HEAT pUMF? & AIP. COOPITIP ER +50
VENTILATING FANS
;EVAPORATIVE CIOLE:
TYPE 111000 (PER 12' OR 12' PTN. OF HOOD)
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CLOTHES DRYER
...........................
€:RANGE' <<
GAS LOG
MISCELLANEOUS (NOT COVERED'
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED GAS APPLIANCE>400,000 B
USED APPLIANCE <400,000 BTU
'"USED APPLIANCE X400,000 t
AIR HANDLER <10,000 CFM
`AIR HANDLE t >10 000 CF
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
- AMOUNT
x 10.00
x 25.00 -
X10.00-
I
x12.00 =
( •
x15.00 -
x 1.00 =
2
x 12.00 =
x 20.00 =
�_-
x 25.00 =
x 35.00 =
x 60.00 -
x 12.00 =
x 20.00 -
x 25.00 in
x 35.00 =
x 60.00 -
x 10.00 -
x 10.00 =
x 50.00 =
X10.00 a
x 10.00 -
/c,2 c"
•
x 10.00 =
•
x10.00 =
x 10.00 =
x 50.00 =
x100.00 =
x 50.00 =
x100.00 =
x12.00 =
x 15.00 =
SUBTOTAL
$
PLUS: PROCESSING FEE
+ $ .e....2.5:00--
EQUALS: TOTAL PERMIT
FEE DUE
nS /o? -
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456 -3675
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