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1992, 07-14 Permit App: 92005217 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM Ott" / l Information Worksheet (08j 26 JOB STREET ADDRESS: .2 7' r.,-,--.10.2/-7? • 10,30'8 Q r (fA CITY/STATE//ZIP: S�Oo�'aiu. T„)/3 PARCEL NUMBER: OWNER: , 2J'n/ k io /.(t PHONE NUMBER: V Y2- 02 7/2 MAILING ADDRESS: I (Street) (City/State) CONTRACTOR: AIRE VALLEY HEATING & cooling LICENSE NUMBER: AIREVHI1410H PHONE NUMBER: 924-0018 MAILING ADDRESS: N. 521 Elia Rd. Spokane, WA 99212 DESCRIPTION (Street) (City/State) MECHANICAL WORKSHEET/FEE SCHEDULE ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) GAS WATER HEATER GAS..EQUIPMf=NT;<1:00 000.STU;(I.NCLUDES `:;:_:: GAS EQUIPMENT +100,000 BTU DUCTWORK) GAS... I G OUT,> :::>:< :> ; < ::<> •"•••• BOILER/REFRIG 1-100M BTU ................................................. BOILER/REFRIG 501-1,000M BTU ............................... SOI.LERIREERIG:1 0001'1` 700 BOILER/REFRIG +1,750M BTU HEAT PUMP & ALRCONDITIONER;;O :TONS HEAT PUMP & AIR CONDITIONER 3-15 TONS HEAT PU:M.P &°AI.R CCNDIT$ONER 15'-30'TONS HEAT PUMP & AIR CONDITIONER 30-50 TONS PUMP &: AIR C:O:N:DITICSNER+50 TONS:i :................:.............................:.::......:. ............:.............:::.: .... . VENTILATING FANS .............................. ................................................................ .............................................................................................. TYPE 1 HOOD (PER 12' OR 12' PTN. OF HOOD) CLOTHES DRYER GAS LOG ........................... .................... MISC.EI LANEOUS NOT COV REC ELSENIHERI UNLISTED GAS APPLIANCE <400,000 BTU ULINSTED GAS' APPLIANCE>400;000 DTU USED APPLIANCE <400,000 BTU USED:>APPLIANCE 400000 BTU:::<> :: AIR HANDLER <10,000 CFM NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE (1-? IScuyvr✓ (Zip) (Zip) NUMBER OF UNITS X EACH UNIT = AMOUNT x 10.00 = x 25.00 = x 10.00 = x 12.00 = X 15.00 = x 1.00 = x 12.00 = x 20.00 = x 25.00 = x 35.00 = x 60.00 = x 12.00 = x20.00 = I / a. , 6t) / •02p" 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 =• x 10.00 = x 10.00 = x 50.00 = x100.00 = x 50.00 = x100.00 = x 12.00 = x 15.00 = • SUBTOTAL $ e2 v • ex) PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE =$ l/ i,5' °--% Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 /Z