1993, 02-09 Permit App: 93000737 Mechanical Fixturesn�r A -1 MECHANICAL, PERMIT APPLICATION FORM
14 9l�� I - Information Worksheet
JOB STREET ADDRESS: 3 (9 6 S - ,�O G!/ U4S!)
CITY/STATE/ZIP: SPd ktf/J/ [) /224 PARCEL NUMBER:
OWNER: 2/9,1V N P/lf 2E&
MAILING ADDRESS: -9c2%7 �t
(Street) (City/State)
CONTRACTOR: AIRE VALLEY HEATING & cooling LICENSE NUMBER: AIREVHI1410H
• PHONE NUMBER: 924-0018
MAILING ADDRESS: N. 521 Ella Rd. Spokane, WA 99212
(Street) (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
PHONE NUMBER: / 7'
(Zip)
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
W000STOVE/INSERT
GAS WATER HEATER
GAS EQUIPMENT <t00,000 BTU (INCLUDES
GAS EQUIPMENT+100,000 BTU DUCTWORK)
GASPIPING,(EAOUTLET)
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG 101 -SOON STU :,'
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG,10001 1,750M BTU_;
BOILER/REFRIG +1,750M BTU
-HEAT PUMP & AIF? CONDITIONER 0-S TONS
HEAT PUMP& AIR CONDITIONER 3-15 TONS
• HEAT PUMP & AIR CONDITIONER 15 30 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
'11EAV PUMP & AIR; CONDITION ER 450 kfro-NSE,i
VENTILATING FANS
EVAPORATIVE COOLERS:>
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE II HOOD
CLOTHES DRYER
,RANGE
GAS LOG
Mscgcvmgovs:INQVComgrtgpligmgw.HplmE
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED GAS APPLIANCE<>400.000;BTU
USED APPLIANCE <400,000 BTU
USED APPLIANCE>400,000BTU ;'.
AIR HANDLER <10,000 CFM
AIR HANDIER>10 000 CFM
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE to
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x 25.00 =
x10.00 =
x 12.00 =
x 15.00 =
x 1.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x35.00 =
x 60.00 =
x 12.00 =
x20.00 =
x 25.00 =
x35.00 =
x 60.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x 10.00 =
x 10.00 =
x10.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x100.00 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
/
/0 00
/
/2.00
/
c2 . 0 0
•
SUBTOTAL
$
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ Y9 ti