1992, 12-14 Permit App: 92010928 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: /// Sq p% h ;0_ Dr,
CITY/STATE/ZIP: 0/e,- PARCEL NUMBER:
OWNER: ij%r' c, �fh y PHONE NUMBER: 9. 4 - O/. i? 9
C2_ 1og2Z
1-3c1
MAILING ADDRES
(Street) (City/State)
CONTRACTOR: AIRE VALLEY HEATING S, 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)
GAS WATER HEATER
:GAS EQUIPMENT <100000 BTU (INCLUDES
GAS EQUIPMENT +100,000 BTU DUCTWORK)
GAS PIPING,(EA:OUTLETY: ,• ..: i.:: ; ;'
•
BOILER/REFRIG 1-100M BTU
BOILEFUREFRIG:1014,00M;BTU
BOILER/REFRIG 501-1,000M BTU
B01LERJREPRIIG.1;0001-1,750M:BTU >' .; , :::
BOILER/REFRIG+1,750M BTU
HEAT PUMP &AIR:CONDITIONER0-3'TONS;;;;:°.':;:^°
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT PUMP`&'AIR CONDITIONER: 15-30 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAL MR &„AIRCONDITIONER;+501ONQ,U_
VENTILATING FANS
EVAPORATIVE COOLERS'
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE tl HOOD...;::'` :: «':'":° <`'?i .. ?°'r: ::.: _;:: ;:.'? `:'°
CLOTHES DRYER
GAS LOG
MISCELLANEOUS (NOT COVERED ELSEWHERE
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED GAS APPLIANCE >400,000BTU
USED APPLIANCE <400,000 BTU
USED APPLIANCE >400,000 ?Ty
AIR HANDLER <10,000 CFM
AIR
HANDLER
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
ecteifin
(Zip)
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x 25.00 =
x10.00 =
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 =
x20.00 =
x 25.00 =
x 35.00 =
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 =
x50.00 =
x100.00 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
/6 --
/A
L
_2
SUBTOTAL
$ d"- Y
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
=$ 97
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675