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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