1991, 10-22 Permit App: 91007053 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM
Information Worksheet
3004
r PARCEL NUMBER:
OWNER: r1Te4.v1 To.c.K4s€ PHONE NUMBER:
JOB STREET ADDRESS: A. I/,,d /
CITY/STATE/ZIP:S otr'i4u.. GU/%
Opp gb,
got y- 7/02
MAILING ADDRESS:
(Street)
CONTRACTOR: AIRE VALLEY HEATING & Cooling
MAILING ADDRESS: N. 521 Ella Rd.
(City/State)
LICENSE NUMBER: ATRFVHT1410H
(Zip)
PHONE NUMBER: 924-0018
Spokane, WA 99212
DESCRIPTION
(Street)
(City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVE/INSERT
GAS WATER HEATER
GAS EQUIPMENT GOO,000 BTU (INCLUDES
GAS EQUIPMENT+100,000 BTU DUCTWORK)
GAS PIPING (EA OUTLET)
BOILER/REFRIG 1-100M BTU
BOIL ER/REFRIG 104,5OOM B'TU
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG 1,00001 1 750M BTU
BOILER/REFRIG +1,750M BTU
HEAT PUMP & AIR CONDITIONER 0 3 TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT PUMP & AIR :CONDITIONER 15 '00 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)
itfAtifitiddifigr
CLOTHES DRYER
GAS LOG
............................................................................................................................
MISCELLANEOUS (NOT COVERED ELSEWHERE:
UNLISTED GAS APPLIANCE <400,000 BTU
............................
ULWSTED GAS APPLIANCE >400,000i.BTU
USED APPLIANCE <400,000 BTU
USED APPL.IANCE>400,000 BTU
AIR HANDLER <10,000 CFM
AIR HANDLER >10 000 CFM
NOTE: MINIMUM PERMIT FEE IS $35.00
(Zip)
NUMBER
OF UNITS
X EACH
. UNIT
= AMOUNT
x 10.00 =
x 25.00 =
x 10.00 =
x12.00 =
x 15.00 =
x1.00 =
x 12.00
x12.00 =
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 =
x10.00=•
x 10.00 =
x 50.00 =
x100.00 =
x50.00 =
x100.00 =
x 12.00 =
x 15.00 =
/
/%--
_
/
/0
-V
SUBTOTAL
$ // i
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
=$ 3
SIGNATUREai? 0. gate 411
U Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675