1991, 11-07 Permit App: 91007670 Mechanical FixturesMECHANICAL PE.Q„MIT APPLICATION FORM
ri#ormation Worksheet
JOB STREET ADDRESS: . // 9j/ Vfa n R CdGcT7-
CITY/STATE/ZIP: Sffp kc Jh (/v . PARCEL NUMBER:
OWNER: .'c./ /.yid a.h,Svn PHONE NUMBER: 7y 7- grS
MAILING ADDRESS:
(Street) (City/State)
CONTRACTOR: AIRE VALLEY HEATING & Cooling LICENSE NUMBER: ATRFV4T141 nH
PHONE NUMBER: 924-0018
MAILING ADDRESS:
N. 521 Ella Rd.
(ZiP)
Spokane, WA 99212
(Street)
(City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
ivglom
GAS WATER HEATER
GA8 QUIZ?MENT to tl TU>(INCl UDES;:;:..::
GAS EQUIPMENT +100,000 BTU DUCTWORK)
pING.:(
BOILER/REFRIG 1-100M BTU
:.............................. ......
S: > l �EI= ::..::
BOILER/REFRIG 501-1,000M BTU
IgpitieF.IntleFR1.0:
BOILER/REFRIG +1,750M BTU
NIP`:: : At Nt11`t'I:l' NER 0- 3 TONS
..................:...:...:::::::::::::.:::::.:::.:::::::::::::..::::::.::::::..:::..::<.::.;
HEAT PUMP & AIR CONDITIONER 3-15 TONS
:..:..........:...:.........................:.............:.........IO.................::........................
H. AT NDiT:>16-3O TONs
HEAT PUMP & AIR CONDITIONER 30-50 TONS
...............................
>EI AT PUMA 'AIR •C•ON•ITION I : •+60. TONS
VENTILATING FANS
EVAPORATIVE COOLS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
CLOTHES DRYER
GAS LOG
:.. . : ERED.::: LSVACHEdi
UNLISTED GAS APPLIANCE <400,000 BTU
•U.f IN5TED GAS'AP • LANCE >400,000:8TU
USED APPLIANCE <400,000 BTU
US O Apt IAN: d00 O00 B
AIR HANDLER <10,000 CFM
Nov iy9 i
NOTE: MINIMUM PERMIT FEE iff'6 ' & SAFETY
SIGNATURE
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x10.00 =
x 25.00 =
x10.00=
x 12.00 =
x 15.00 =
x 1.00 =
x12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 12.00 =
x 20.00 =
x25.00 =
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 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
/
/0=°
/02
02
a, `2."-
;x
•
SUBTOTAL
$ .2 V.00
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ 'I 9.60
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675