1992, 07-27 Permit App: 92005764 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: /7 oZ D S�- "` (1)7 14) Yy �.
CITY/STATE/ZIP: <Y1C2-- PARCEL NUMBER:
OWNER: r re.// 7-6a.S PHONE NUMBER: ga21?' - 02 Y7a_
MAILING ADDRESS:
(Zip)
01.2 - 5rlCo4
(Street) (City/State)
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)
O. DO:+�S S
GAS WATER HEATER
GAS.EQUIPMENT <'100 000 BTU<(INCt UDES'; <<;
GAS EQUIPMENT +100,000 BTU DUCTWORK)
GAS. PIPING:
BOILER/REFRIG 1-100M BTU
BOPLEFUR PIG> I0•1< 5± OMflTU:><:>
BOILER/REFRIG 501-1,000M BTU
BQI LER/REFI:IG>1000:'I'[7°5M.;
BOILER/REFRIG +1,750M BTU
HETAT PUMP &AIR Of DI r1ONER 0 TONS>
HEAT PUMP & AIR CONDITIONER 3-15 TONS
oNDifIONEFI 15-t
HEAT PUMP & AIR CONDITIONER 30-50 TONS
H$ T PuNif' & AIR::CONDIT.I.ONER +5
VENTILATINGI FANS
V...14.:.>A; V::...:.....:::
:.;FORA:�:.::ECOON::I.S:<>.;:.:::::.>:.;:.:::.;,:;..:..;:.::.:<.::............. ;::.::
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
CLOTHES DRYER
GAS LOG
Ml$O LLANEOUS COVERED`%L'S
UNLISTED GAS APPLIANCE <400,000 BTU
ULIN T D; AS APPLIANC>40O0001 'itU
USED APPLIANCE <400,000 BTU
USED,APPLIAN.GE*400f0000TU<<
AIR HANDLER <10,000 CFM
AIR:0ANOL
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
- AMOUNT
x 10.00 -
x25.00 =
x10.00=
/6%
x 12.00 =
/02 i-----
x 15.00 =
x 1.00 -
d O3_
x 12.00 =
x 20.00 =
x 25.00 =
x35.00 =
x 60.00 =
x12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 10.00 -
x 10.00 =
x50.00 =
x 10.00 =
x 10.00 MI
,
•
•
X MOO =•
•
X 10.00 =
X 10.00 =
x 50.00 =
x100.00 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
SUBTOTAL
$ (,2 y
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ yq,Db
etaiit
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675