1993, 06-04 Permit App: 93004287 AC:i
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MECHANICAL PERMIT APPLICATION FORM
/ /Information Worksheet
/v
JOB STREET ADDRESS: 9// 0 ez, 6
CITY/STATE/ZIP: S/AOi ,/& PARCEL NUMBER:
34gaa7
1y �S
OWNER: /l%/f7Z/en) 16 f42,M (,1 PHONE NUMBER: 9d 6 3 93 -
MAILING ADDRESS:
(Street)
CONTRACTOR:AIRE VALLEY HEATING
MAILING ADDRESS: 571 N F.T
(CitylState)
(Zip)
LICENSE NUMBER:_ATREVHT 1 41 OH
PHONE NUMBER:
.T.A RnAh SPOKANP, W4
(Street) - (CitylState)
MECHANICAL WORK
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVE/INSERL.-.'s;: ";:_ ',
GAS WATER HEATER
GAS:EQUIPMENT,100,000 BTU (INCLUDES'?
GAS EQUIPMENT+100,000 BTU DUCTWORK) .
BOILER/REFRIG 1-100M BTU
B O I LE RJ R E R I G x'101 -500M .BTU
BOILER/REFRIG 501-1,000M BTU
BOILEIi/REFRIO,!1;0001.1;750M'tit
U.':`:i'.;'>:':
BOILER/REFFIIG +1,750M BTU
HEAT PUMP;&'AIR. CONDITIONER:0 3iTON$: 'r '::
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT PUMP:&;AIONDITIONER'. 15-30 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
• HEAT. P.UIvlP'& AIR CONDITIONER +5U
VENTILATING FANS
•EVAPORATIVE COOLERS` .:,.;;::":i::::-
TYPE I HOOD (PER (PER 12' OR 12' PTN. OF HOOD)
TYPEIIHOot�,:::;`'.i'i?'', :1'`. ra z,.ir.,:;.::,c:'
CLOTHES DRYER
RANGE
GAS LOG
MISCELLANEOU5:.(NOT COVERED ELSEWHERE:
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED GAS`APPLIANCE>400,000 BTU
USED APPLIANCE <400,000 BTU
•USED APPLIANCE>400,tl00.Btu ':';;;:;.t'',;';,;:.?.'
AIR HANDLER <10,000 CFM
AIR HANDLER'.>10,000'.CFM; ;. (.,
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
99212
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x 25.00 =
x 10.00 =
x 12.00 --
x 15.00 =
x
x 1.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x35.00 --
x 60.00
x60.00 =
x12.00 =
x 20.00 =
x 25.00 --
x 35.00
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 =
/
/2 00
•
x 50.00 =
x100.00 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
SUBTOTAL
$ /5.00
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
=$ g7
-s"rf4
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675