1991, 08-16 Permit App: 91005076 AC• MECHANICAL PgRMIT APPLICATION FORM
• Inforiaation W rksheet
JOB STREET ADDRESS: S. 4/19'
• CITY/STATE/ZIP: fOZO e 7-91 ?,2 6 PARCEL NUMBER:
OWNER: CJ PHONE NUMBER:
MAILING ADDRESS:
(Street) (City/State) (Zip)
CONTRACTOR: Aire Valley Heating & Cooling LICENSE NUMBER: AIREVHI1410H
MAILING ADDRESS: N. 521 Ella Rd.
PHONE NUMBER: 924-0018
Spokane, WA. 99212
(Street) (City/State) (Zip)
MECHANICAL WORKSHEET!FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
GAS WATER HEATER
A.- • • •BTLJ bESJ
GAS EOUIPMENT +100,000 BTU DUCTWORK)
BOILER/REFRIG 1-100M BTU - •
Ltittli:VORIVOITAINOR.10.13111111111111.101L4.
BOILER/REFRIG 501-1 ,000M BTU::
,......PWARAIINATMORATCONSIOW,
BOILER/REFRIG +1,750M STU
igAgette*Atfropignimpoptfe.4t0$HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT101111kit
„ „ „
HEAT PUMP & AIR CONDITIONER 30-50 TONS •
irt410*101:03::'p,popntoo014:0,4*.t.:04§r
VENTILATING FANS ''''' •
igyAgglaglygpooimoviggigismossestoons
TYPE lHOOD (PER 12' OR 12' PTN. OF
.itEity.dtsxizg.imnsuggm.v.mm
?•ifxVe
CLOTHES DRYER
NUMBER
OF UNITS
X EACH
UNIT
=AMOUNT
E'ror.' 4V SOD INOT-00
UNUSTED GAS APPUANCE <400,000
0
USED APPLIANCE <400,000 BTU
x 10.00 =
x25.00
x 10.00 =
x 12.00 =I
•
x 15.00 =
x 1.00 =
x 12.00 =
x 20.00 2:
X 25.00 I=
x3500=
x 60.00 =
x12.00 = •4'19'
x 20.00z =
x25.00
t
x 35.00 se
x 60.00 se'
x10.00 =
x10.00 es '
•x 50.00 =
x 10.00 =
MREDIVANIIEV.
•
• ''tk • .4006
• .
AIR HANDLER <10,000 CFM : •
904157—
NOTE MINIMUM PERMIT FEE IS $35.00
SIGNATURE
1) s6citi//21
SUBTOTAL
X 1 0.00 =
t
X lb° SU•
x50.00 =
X1 00600 11111
x50.00
)(1 00*00
x12.00 ai
x 15.00 se
PLUS: PROCESSING FEE
EQUALS: TOTAL PERMIT
FEE DUE
+ $ 25.00
.$ Op
Spokane County Division of Buildings
• West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675