1992, 03-24 Permit App: 92001788 Mechanical Fixtures6-3t p `� a C5 5 MECHANICAL' PERMIT APPLICATION FORM
p f i Information Worksheet
JOB STREET ADDRESS: N. //O 9 Fa -/7 •
-
CITY/STATE/ZIP:-51P4nas 1,4,4 PARCEL NUMBER:
OWNER: re. /ju,„ T PHONE NUMBER: 9'22.2 - cfl '
MAILING ADDRESS:
(Street) (City/State)
CONTRACTOR: AIRE VALLEY HEATING & cooling LICENSE NUMBER: AIREVHI1410H
PHONE NUMBER: 924-0018
MAILING ADDRESS: N. 521 Ella Rd. Spokane, WA 99212
(Street)
(City/State)
61; -r`.c2", Ct MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVE/INSERT
GAS WATER HEATER
GAS EQUIPMENT <100,000 BTU (INCLUDES
GAS EQUIPMENT+100,000 BTU DUCTWORK)
GAS PIPING (EA 'OUTLET)
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG 101500M 6TU
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG 1,000E -1,750M 6TU':
BOILER/REFRIG +1,750M BTU
HEAT PUMP & AIR CONDITIONER 6-3'IONS '.;::
HEAT PUMP & AIR CONDITIONER 3-15 TONS
• HEAT PUMP & AIR CONDITIONER:15-30 TONS'.:.
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT PUMP & AIR 'CONDITIONER 450 TONS
VENTILATING FANS
EVAPORATIVE COOLERS,.;:
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE If HOOD :: r:::'<.`;.; :`_?:.;,
CLOTHES DRYER
GAS LOG
MISCELLANEOUS (NOTC.OVERED ELSEWHERE i :..
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED GAS APP.LIANCE>400,000'BTU''
USED APPLIANCE <400,000 BTU
USED:APPLIANCEa400;000 BTU
AIR HANDLER <10,000 CFM
AIR:HANDLER>10;000 CFM
NOTE: MINIMUM PERMIT FEE IS $35.00
(Zip)
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x10.00 =
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 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x 10.00 =
x10.00 =
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 =
/
/1' °'
SUBTOTAL
$ /3. 00
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ 3 P. eo
SIGNATURE &ty 00- gGGL!/j'l
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675