1993, 04-14 Permit App: 93002473 ACMECHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: 2
CITY/STATE/ZIP:
LJ"/I
OWNER:��
MAILING ADDRESS:
1 J t J_j
%7 7 )
PARCEL NUMBER:
PHONE NUMBER:
(Street)
(City/State)
CONTRACTOR: AIRE VALLEY HEATING & Cooling LICENSE NUMBER: ATPRVHT141 ON
PHONE NUMBER: 924-0018
(Zip)
MAILING ADDRESS: N. 521 Ella Rd. Spokane, WA 99212
(Street)
MECHANICAL WORK
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
GAS WATER HEATER
GAS EQUIPMENT +100,000 BTU DUCTWORK)
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG +1,750M BTU
NEAT P M #I t CONDITIONS •0 TANS......
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT PU.M '. & AICA CONDITIONER' 5-3 •T•
ONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HE PUMP & AIR CONDITIONER+5 •
TANS
VENTILATING FANS
TYPE I HOOD (PER 12OR 12' PTN. OF HOOD)
GAS LOG
'MISCELt_;
►VENUS (NOT C V RED E�SEWH
UNLISTED GAS APPLIANCE <400,000 BTU
ULINST D GAS APp�tANCE 400,000 RTU
USED APPLIANCE <400,000 BTU
AIR HANDLER <10,000 CFM
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
(City/State)
(Zip)
' NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
_
' .00
x 25
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 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 50.00 =
.
/'''..? 00
•
•
x100.00 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
SUBTOTAL
$ / .%L'
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ %"
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675