1992, 06-17 Permit App: 92004389 Mechanical Fixtures\j c
JOB STREET ADDRESS:
CITY/STATE/ZIP:
MAILING ADDRESS:
MECHANICAL PERMIT APPLICATION FORM
(Street)
Informatlot! Worksh6et
2 2 6
PARCEL NUMBER:
PHONE NUMBER: LK42
(City/State) ,
CONTRACTOR:, AIRE VALLEY HEATING & cooling -LICENSE NUMBER: AIREVHI 1410H
PHONE NUMBER: 924-0018
(zip)
MAILING ADDRESS: N. 521 Ella Rd. Spokane, WA 99212
(Street) (City/State) (zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
O
....... ..........
... . . ......
........... .... . ...... .. . . ......
CLOTHES DRYER
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE -
NUMBER
OF UNITS
X EACH
UNIT
Q AMOUNT
x 10.00 -
x 25.00 -
x10.00=
x 12.00 =
x 15.00 =
x 1.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 -
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 -
X 10.00 =
x 10.00 =
x 50.00 -
x 10.00 =
x 10.00 =
x 10.00 -
x 10.00 =
x 10.00 =
x 50.00 =
x100.00 =
x 50.00 =
X100.00 =
x 12.00 =
x 15.00
_2
11Z
SUBTOTAL
s .2 ao
PLUS: PROCESSING FEE
+$ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
=$ y7.06
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675