1992, 07-27 Permit App: 92005766 ACt�5 \L\ a 1 A;--
j " MECHANICAL PERMIT APPLICATION FORM
OVQ ���_ � - - inforinatIoniVorksheet
JOB STREET ADDRESS: / y/l - -
CITY/STATE/ZIP: Sr oka stat 1,,//4- •
OWNER: V 2 J f' A f 1'u- F/ ' r
MAILING ADDRESS:
PARCEL NUMBER:
PHONE NUMBER:
cAZ-7«a
cocc7
y 2&- y9,s-?
(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)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS
:.......
{
Wi�STOVEII,t0.E.At::........' . ' :;
GAS WATER HEATER
GAS. EQUIPMENT <TOo,n00 BTU (INCLUDES .
GAS EQUIPMENT +100,000 BTU DUCTWORK)
GAS PiPINc3 (EA OUTLET) .:.:.....
BOILER/REFRIG 1-100M BTU
..............................
.OILEf /REFAIG
BOILER/REFRIG 501-1,000M BTU
BOILER/REEF
BOILER/REFRIG +1,750M BTU
HEAT ?UMP AIf +ONDITIONER t1- TONS :!
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
VENTILATING FANS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
CLOTHES DRYER
GAS LOG •
MISCELLANEOUS (N1,p. T COVERED ELSEW,I
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTEb GAS; PPLtANCE�40pt100 STU
USED APPLIANCE <400,000 BTU
USED APPLIANCE >40O,000.BTU
AIR HANDLER <10,000 CFM
All HANDLER 10,000•
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE_LAJ w Liao
tol
(Zip)
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 -
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 =
x12.00=
x 20.00 =
x 25.00 =
x35.00=
x 60.00 =
x 10.00 -
X 10.00 =
x 50.00 =
x 10.00 =
x 10.00 -
x10.00 =
X 10.00 =
X 10.00 =
x 50.00 =
x100.00 =
x 50.00 -
x100.00 -
x 12.00 =
x 15.00 =
/
00
• •
SUBTOTAL
$ /„z
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ 3 7.0
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675