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1993, 04-02 Permit App: 93002085 Mechanical Fixtures
:a r ,; iry MECHANICAL PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: 2 // 973 ,c.eEZ7tL/oK CITY/STATE/ZIP: 6',420/Cif /Vie ,� PARCEL NUMBER: �-I'-_ 0 a ' 1.3/ 3' OWNER: ,L)//�//d,4T V gl✓7.QF//fPHONE NUMBER: MAILING ADDRESS: �,4//i'T q3- -7 (Street) (City/State) CONTRACTOR: AIRE VALLEY HEATING & Coot i ng LICENSE NUMBER: ATRFVHT141 nH PHONE NUMBER: 924-0018 MAILING ADDRESS: N. 521 Ella Rd. (Zip) Spokane, WA 99212 DESCRIPTION (Street) (CIty/State) MECHANICAL WORKSHEET/FEE SCHEDULE ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) W000STOVE/INSSRT GAS WATER HEATER OAS EQUIPMENT <100,000 BTU (INCLUDES::: GAS EQUIPMENT +100,000 BTU DUCTWORK) ................... ....... . GAS;PIPING:(EAOUTLET):..:::::::: r:[ BOILER/REFRIG 1-100M BTU Bo.I.IER/REFBI0:::10140 ,M BTU BOILER/REFRIG 501-1,000M BTU `BOILER/REERIG1.0001: 1,750M;BTU ':i ::. :': ::: BOILER/REFRIG +1,750M BTU HEAT;PUMP::&;A,IP CONDITIONER'0-S TONS,, y;- HEAT PUMP & AIR CONDITIONER 3-15 TONS HEAT;PUMP:&AIR_OONDITIONER1530 TONS'.- HEAT PUMP & AIR CONDITIONER 30-50 TONS HEAT:PUMP::&`AIR:CONDITLO.NER:+50:TONS''.:: s ::.:: VENTILATING FANS ' EVAPORATIVE COOLERS l TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) CLOTHES DRYER GAS LOG MISCELLANEOUS (NOT_ COVERED:ELSEWHERE _:':_ UNLISTED GAS APPLIANCE <400,000 BTU ULINSTEID GAS APPLIANCE>400,000BTU USED APPLIANCE <400,000 BTU USED: APPLIANCE>400000 BTUr AIR HANDLER <10,000 CFM AIR:HANDLER;>10;O000,M_ NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE (Zip) NUMBER OF UNITS X EACH UNIT = AMOUNT x10.00 = x25.00 = x 10.00 = x 12.00 = x 15.00 = x 1.00 = x12.00 = x 20.00 = x 25.00 = x 35.00 = x 60.00 = x 12.00 = x 20.00 = x25.00 = x 35.00 = x 60.00 = x 10.00 = x 10.00 = x 50.00 = x10.00 = 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 = / /0.0 0 / /9-. 6V 09-:00 SUBTOTAL $ 2w PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE =$ en'G% Spokane County Division of Buildings 9 14 West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675