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1992, 06-15 Permit App: 92004321 Mechanical Fixtures0 TP ' X020 MECHANICAL PERM! "APPLICATION FORM �� g /� ( Information Worksheet JOB STREET ADDRESS: AL t2 6 , /4' CITY/STATE/ZIP: r Sek i. "17p 1.(}1)-. PARCEL NUMBER: OWNER: G`J !. , S Ti e / C1 PHONE NUMBER: MAILING ADDRESS: c/ (Zip) -(43/ 77a 7yo y (Street) (City/State) CONTRACTOR: AIRE VALLEY HEATING & cooling LICENSE NUMBER: AIREVHI1410H PHONE NUMBER: 924-0018 MAILING ADDRESS: N. 521 Elia Rd. Spokane, WA 99212 (Street) (City/State) MECHANICAL WORK DESCRIPTION ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) GAS WATER HEATER GAS.. EQUIPMENT <iO0,050;8TU (IN.Cl UDES GAS EQUIPMENT +100,000 BTU DUCTWORK) GAS' IPIN.G. T p... ...............:........... BOILER/REFRIG 1-100M BTU a lt*9Fi .;� G........ �-500.8<X;U.>:.:>:.>::.> BOILER/REFRIG 501-1,000M BTU t O.i.LER/.fEFf IG.:„:.. 0001: BOILER/REFRIG +1,750M BTU HEAT PUMP &;AII' ::CONDITIONEta0-3 TON.S'`'<»> > < HEAT PUMP & AIR CONDITIONER 3-15 TONS ............ ,..........::.............. . HEAT PUMP &AIR:>CONDITIONE t<15'-30• HEAT PUMP & AIR CONDITIONER 30-50 TONS VENTILATING FANS TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) i ThrNoir: CLOTHES DRYER GAS LOG MISCELLANEOUS (NOT: COV I D ELS WH. RE UNLISTED GAS APPLIANCE <400,000 BTU ULINSTED GAS' AP:PLIANCE>400,000.`DTU USED APPLIANCE <400,000 BTU USED: PP IA E>4 0`B AIR HANDLER <10,000 CFM D >: tl.Q.Q.CSM::<.;;::.::::.::.:::::;.;:.: NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE (Zip) NUMBER OF UNITS X EACH UNIT - AMOUNT x 10.00 m x 25.00 - x10.00= /d°% x12.00 = /c;2 ofl x 15.00 = x 1.00 = od °= x 12.00 = x20.00 = x 25.00 = x35.00 = x 60.00 = x 12.00 = x 20.00 = x25.00 = x35.00 = x 60.00 = x 10.00 n x 10.00 = x 50.00 = x 10.00 = x10.00 = • • x 10.00 =• • x 10.00 = x 10.00 .1-- x 50.00 = x x100.00 = x 50.00 = X100.00 = x 12.00 = x 15.00 = SUBTOTAL $ may. co PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE =$ y,-.0 Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675