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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