1993, 03-09 Permit App: 93001340 Mechanical Fixtures-4,k7-11 MECHANICAL PERMIT APPLICATION FORM
LA P!.! -
Information Worksheet
JOB STREET ADDRESS: -4/ _„,11
CITY/STATE/ZIP:
OWNER:
MAILING ADDRESS:
PARCEL NUMBER:
PHONE NUMBER:
70,9
(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 WORK
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
GAS WATER HEATER
GAS EQUIPMENT.<1 00,000. BTU (INCLUDES
GAS EQUIPMENT +100,000 BTU DUCTWORK)
GAS PIPING (EA..OUTLEfl ..
BOILER/REFRIG 1-100M BTU
9OILR/REFRIG 101 -500M BTU
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG 1,0001-1,750M BTU
BOILER/REFRIG +1,750M BTU
HEAT PUMP & AIR CONDITIONER 0- TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
f(t400***04i:;00NOrtioN:"••..-7""""'"'•
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT PUMP & AIR CONDITIONER +50 TONS,
VENTILATING FANS
EVAPORATIVE pogL.....::
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
CLOTHES DRYER
RANGE 1
GAS LOG
MISCELLANEOUS (NOT
UNLISTED GAS APPLIANCE <400,000 BTU
"..'•••-•4:0 U•
USED APPLIANCE <400,000 BTU
vsgt)Apput•ANqgii.401;00(y.B.,
AIR HANDLER <10,000 CFM
AIR HANDLER >10,000 CEM :
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
(Zip)
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x10.00 =
x 25.00 =
x10.00 =
x12.00 =
x 15.00 =
x 1.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x10.00 =
x10.00 =
x 50.00 =
x10.00 =
x10.00 =
x 10.00 =
x10.00 =
x10.00 =
x 50.00 =
x100.00 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
/2•(7-)
/
.
•
• •
.
SUBTOTAL
$
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
2?()6
=$ ,
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675