1993, 05-14 Permit App: 93003504 Mechanical Fixturesv
t= CP3-:5oy
MECHANICAL PERMIT APPLICATION FORM 4-11173
/ Information Worksheet NA55)ur gcte,'
JOB STREET ADDRESS: /l/ /30c/ L O C l/ s/ ` �"t 3 L 5
CITY/STATE/ZIP: ,C/iao,e4�e 99. C C7 6 PARCEL NUMBER: S) 2 •DJC
OWNER: /1% /(47ELg 205L L4 PHONE NUMBER: ;7V «- D 3/
MAILING ADDRESS: .Vfi
(Street) (City/State)
CONTRACTOR: AIRE VALLEY HEATING & CooJ in0 LICENSE NUMBER: ATRFVHT141 nu
PHONE NUMBER: 924-0018
MAILING ADDRESS: N. 521 Ella Rd.
(Zip)
Spokane, WA
99212
(Street) (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
wOODSTOVE/INSERT::..:.... .:::
GAS WATER HEATER
GAS EQUIPMENT.<100;000 BTU (INCLUDES".
GAS EQUIPMENT+100,000 BTU DUCTWORK)
GAS PIPING (E) OUTLET)
BOILER/REFRIG 1-100M BTU
:90,ILER/REFRIG.1O1-s00M BTU
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG 1,0001=1,750M BTU:
BOILER/REFRIG +1,750M BTU
HEAT::PUMP & AIR CONDITIONER'0-3 TONS..,
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT:PUMP& AIR CONDITIONER 15-30;TONSi,._;:
HEAT PUMP & AIR CONDITIONER 30-50 TONS
:HEAT: PUMP & AIRCONDITIONER +50'.TONS
VENTILATING FANS
'EVAPOI9ATIVE COOLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE II:HOOD.
CLOTHES DRYER
RANGE
GAS LOG
MISCELLANEOUS (NOT COVERED ELSEWHERE
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED GAS APPLIANCE >400,000:BTU.:'i
USED APPLIANCE <400,000 BTU
USED APPLIANCE >400,000 BTU
AIR HANDLER <10,000 CFM
AIR HANDLER 5.10,000 CFM
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
Creat
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x 25.00 =
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 =
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 =
x 10.00 =
x10.00 =
/
/ 0 00
/
/J.0O
02
d2.0u
/
/0.00
x 10.00 =
x 50.00 =
x100.00 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
SUBTOTAL
$ e7
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
6: (6✓
= $