1991, 10-08 Permit App: 91006639 Furnace, PipingMECI- .:1ICAL PERMIT APPLICATION FOGA
/ Information Worksheet
JOB STREET ADDRESS: N. c. S�
CITY/STATE/ZIP: St0/ea 9 l�2/,2 PARCEL NUMBER: E 2 . `1. h -b
OWNER: (1. n .L U' i e.Us Buss c.. PHONE NUMBER: 9'cZ 7 - t2 P %(o
MAILING ADDRESS:
(Street) (City/State)
CONTRACTOR: AIRE VALLEY HEATING & Cooling LICENSE NUMBER: ATRFVNT141 O4
PHONE NUMBER: 924-0018
MAILING ADDRESS: N. 521 Ella Rd.
Spokane, WA
99212
(ZiP)
DESCRIPTION
(Street)
(City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
GAS WATER HEATER
CAS E4 UIPMENT><100,000>911) (rINCLUDES <:'
GAS EQUIPMENT +100,000 BTU DUCTWORK)
BOILER/REFRIG 1-100M BTU
:f401LBg...Rft�..1.t11.-X500......0...i1...................................
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG +1,750M BTU
&AIR NI M31)N
.................................................................................................::...........
HEAT PUMP & AIR CONDITIONER 3-15 TONS
AIS> :O DITION is>1`5` 3C1:":TUNS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
CONDITIONE,R;;; $O TONS > ;
......:...:..:............:........:..:...::.:....:...:.......:....::........:..:..................:.........:.. .
VENTILATING FANS
..... ..........
IAT
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
CLOTHES DRYER
...:...:.::............
GAS LOG
M,1SC U A'4EOU$ (N 7' NI=RgD : LS WIH0R
UNLISTED GAS APPLIANCE <400,000 BTU
ULIN.S') ED GAS: APPt IANCE';>400,000:RTU •
USED APPLIANCE <400,000 BTU
USED APPLIANCE' 00 000.;BTU
AIR HANDLER <10,000 CFM
..................................................
AI.INAN....ERQQ
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
(ZiP)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x 25.00 =
x 10.00 =
x12.00 =
x 15.00 =
x 1.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x12.00 =
x20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 10.00 =
x10.00 =
x 50.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x100.00 =
x50.00 =
x100.00 =
x 12.00 =
x15.00 =
/.
/
/ a'
•
SUBTOTAL
$ /, 3
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ 3 r-=
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675