1992, 01-02 Permit App: 92000017 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: / ,/ 9 5. 'Eu. r AS
CITY/STATE/ZIP: I/c-Padb.Le,, LJ . /,903 7 PARCEL NUMBER:
OWNER: f%Lk.r/< S 7-4.J PHONE NUMBER: 9.2/- D 7c 7
MAILING ADDRESS:
(Street)
(City/State) (Zip)
CONTRACTOR: AIRE VALLEY HEATING & cooling LICENSE NUMBER: AIREVHI1410H
PHONE NUMBER: 924-0018
MAILING ADDRESS: N. 521 Ella Rd. Spokane, WA 99212
DESCRIPTION
(Street)
(City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
SART
GAS WATER HEATER
:GAS;EQUIPMENT <100 000::STU (INCLU: ES':
GAS EQUIPMENT +100,000 BTU DUCTWORK)
GAS::PIPING' E:O.UT(- '><
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG
BOILER/REFRIG 501-1,000M BTU
OOI.l-ERIREFJG::1;000
BOILER/REFRIG +1,750M BTU
HEAT f UMP' AI `GO DITIONEA 0:-3 `LOI S<' `
HEAT PUMP & AIR CONDITIONER 3-15 TONS
H AT PUIvIP`_&'AIR` CONPIM:,
R 15-30 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
;;HEAT:P.UM.P & AIR ONDITIONER;+50 TONS '
VENTILATING FANS
VAIRIQRAT.M:i0
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
CLOTHES DRYER
..............................
RANGE >;
GAS LOG
M S L A SOUS (N T C...:syERED E SEIN.HER
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED GAS:APPLIANCE:>400,000 BTU
USED APPLIANCE <400,000 BTU
USED;APP JANCE>>400;000 BTU
AIR HANDLER <10,000 CFM
AIR: HANOLER>100• •
.........•............
.................. .
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE cgteirgetr.�.ss4
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x10.00 =
x 25.00 =
x10.00 =
x 12.00 =
x15.00 =
x1.00 =
x 12.00 -
x 20.00 =
x 25.00 =
x 35.00 =
X 60.00 =
x 12.00 =
X 20.00 =
x 25.00 =
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 =
/
/p
/
/-2. 1=