1992, 09-23 Permit App: 92007990 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM 9a ` -19c10
- Information Worksheet j Q
JOB STREET ADDRESS: J 3 0 8 , 4 -ono ,c, -ie_ l/ D ( ` u 2,/ 4
CITY/STATE/ZIP: sOGjea 2?l V4 • PARCEL NUMBER:
OWNER: ,9:k2- 7%70 MS cr.)/ PHONE NUMBER: ?„2/ 302/3
MAILING ADDRESS:
(Street) (City/State)
CONTRACTOR: AIRE VALLEY HEATING & Cooling LICENSE NUMBER: ATRFVHT141 C)H
PHONE NUMBER: 924-0018
MAILING ADDRESS: N. 521 Ella Rd.
DESCRIPTION
(Zip)
Spokane, WA
99212
(Street)
(City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
.........................................
ogrp
V
GAS WATER HEATER
GAS EQUIPMENT <100,000 BTU (INCLUDE
GAS EQUIPMENT +100,000 BTU DUCTWORK)
GAS PIPING (BA OUTLET):........ .
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG 501-1,000M BTU
..................................................... ...... .....
..........................
BQILER1REPI 1G
BOILER/REFRIG +1,750M BTU
H ATPUM &All CONI
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT P IMP & AtR CtNPITIQNER 15 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
NEAT:PUMP.& All .CONDITIONER +50 TONS
..................................................................................................................:
.....................................................................................................................
VENTILATING FANS
EV:....O:.:.A..::V::::::....:::..:.:.:::.::.:::::..
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
CLOTHES DRYER
GAS LOG
M...I:SCE NEOUS (NOT C yg.9.gviKsgm.iER
UNLISTED GAS APPLIANCE <400,000 BTU
UI INSTED GAS APP IANC >400',000'BTU
USED APPLIANCE <400,000 BTU
USED APP .I INCE 0Q,{ 00 BTU
AIR HANDLER <10,000 CFM
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
(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 =
x 10.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x100.00 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
/
/QD.-='--
%a
02
o2
SUBTOTAL
$ Y
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
=$ 4/?`9.
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675