1991, 05-28 Permit App: 91002910 Furnace, PipingMECHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: , / SO E� toad AA.,
CITY/STATE/ZIP: S 4/t it:e,, Gti . 99.216. PARCEL NUMBER:
OWNER: ,DoC ?- &t,' If 077 b 71 PHONE NUMBER:
MAILING ADDRESS:
(Street) (City/State) (Zip)
CONTRACTOR: Aire Valley Heating & Cooling LICENSE NUMBER: AIREVHI1410H
PHONE NUMBER:
MAILING ADDRESS: N. 521 Ella Rd.
Spokane, WA.
99212
(Street)
MECHANICAL WOR
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
GAS WATER HEATER
GAS EQUIPMENT +100,000 BTU DUCTWORK)
GAS :.;IPI .. EA QUILE:.
BOILER/REFRIG 1-100M BTU
-7444.01:111101101:00:1::: 1.,101111111-
:'{ri4:::}i::3i•}i:•:i:>.::.: -:..:.
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG +1,750M BTU
HEAT PUM <i AIR CONDITION R:0- TONS<>
HEAT PUMP & AIR CONDITIONER 3-15 TONS
.. PUMEAAI;.;:CONDI.TION
HEAT PUMP & AIR CONDITIONER 30-50 TONS
CONDITIONER t5070NS„`: < !:
VENTILATING FANS
E A ,RATtYI"L
Y... PO:>G4Q
....................................................................................................................
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
CLOTHES DRYER
GAS LOG
..,�..� ,...:. ,�.•::.� �.,,.::.. �•-,; ^rte
UNLISTED GAS APPLIANCE <400,000 BTU
t ltd ekg v'.": t '.:.i...� :: F.:±•;;.�!:_{ ;itj:••�.'`��;�uT}'v:{::'v .`Yiv' '.
USED APPUANCE <400,000 BTU
AIR HANDLER <10,000 CFM
y ,.x:.;.:: yp;.,,wo•.ar.•«r•:::.y.:.;:r7Fi::'X�y�j6 •.<r:Ysf;:y� �_�:. ,ya�.xa:.:•r:-E:r�:
NOTE: MINIMUM PERMIT FEE IS $35.00
(City/State)
Rip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00
x 25.00
x10.00
x12.00
x 15.00
x 1.00
x 12.00
x 20.00
x 25.00
x 35.00
x 60.00
x 12.00
x 20.00
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
x10.00
x50.00
x100.00
x 50.00
x100.00
x 12.00
x15.00
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
/ao
f.3-
. ,
SUBTOTAL
$ / 3 =''
PLUS: PROCESSING FEE
'
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
=$ �$ ®%
SIGNATURE
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675