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1991, 06-25 Permit App: 91003504 Mechanical Fixtures
MECHANICAL PERMIT APPLICATION FORM .C3G- Information Worksheet JOB STREET ADDRESS: _ / 3..3 09 (po, - CITY/STATE/ZIP: S'c7/ice n.e , 14)4. 9 9G2/L 13AR6EL NUMBER:/ -5"S -/ c� / OWNER: %c 0 n 277a -vi n PHONE NUMBER: MAILING ADDRESS: •S c Ott, &i'u��r i�_s G'.CY �Y • (Street) (City/State) / (Zip) CONTRACTOR: Aire Valley Heating & Cooling LICENSE NUMBER: AIREVHI1410H MAILING ADDRESS: N. 521 Ella Rd. PHONE NUMBER: 924-0018 Spokane, WA. 99212 DESCRIPTION (Street) (City/State) MECHANICAL WORKSHEET/FEE SCHEDULE ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) GAS WATER HEATER GAS EQUIPMENT +100,000 BTU DUCTWORK) BOILER/REFRIG 1-100M BTU • ..:-;+'•:^••iw: x.,: : S:>N }�v.�ynv,v.}:.;•,:xuv` •--•.: pC !1 I.1*f 1.G. 1::*�::7,7�118't ll<:;;:::.?h: - ;•>..? .<:.: {.y? ,;;:.:. BOILER/REFRIG 501-1,000M BTU BOILER/REFRIG +1,750M BTU HEAT PUMP AIR :ONDItIONEI:1�-3.;TONS>::>'::>>::<:<:>;;:::<»:: HEAT PUMP & AIR CONDITIONER 3-15 TONS ........................................ .......................... HEAD':P.U.M.P<&>AIR;>�GO.NDITIO.NER 1. 0TQN.S <>>ry ;::::.�:::n:: n ; n..: ;r.w::.v �:v::; .::: .:..........:..........gin:...... h..... TONS .: ...4-..h n•v�, f... HEAT PUMP & AIR CONDITIONER 30-50 TONS EAT`: VENTILATING FANS EVAPORAXIV E;OOOLEpS: TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) TYPEii:HO CLOTHES DRYER GASLOG::.:.::...�:.y........:...K'.:....,...}.�..t..�........:.::..:..:..:.:::.....::............................. r: •:'.vvn..: v•.: :.. .::.vY.v-:•::.:. --._:.:gin .:. :•:: :•.:-.: ., .- ... nGf•• {`viR UNLISTED GAS APPLIANCE <400,000 BTU USED APPUANCE <400,000 BTU ie:::::}.v:"ytom! yr..yv. `•• gr?q{ytTr ii:SaA:hxiJiSvrhx:;nKif�f; AIR HANDLER <10,000 CFM •K.yvw.ypy: nN,•. rra:.;:. NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE 6etton NUMBER OF UNITS X EACH UNIT = AMOUNT x10.00 = x 25.00 = x10.00 = x 12.00 = x15.00 = x 1.00 = x 12.00 = x20.00 = x 25.00 = x 35.00 = x 60.00 = x 12.00 = x20.00= 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 = x 50.00 = X100.00 = x 12.00 - x 15.00 = / /Q - \ f !,2 o� J %-.- . , y4';, .": / l aoT . ---.. . . SUBTOTAL $ 35 °'i. PLUS: PROCESSING FEE + $ 25.00 • EQUALS: TOTAL PERMIT FEE DUE =$ 60.00 Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 .11