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1991, 12-04 Permit App: 91008376 Mechanical Fixtures
35.4 t - y��e f MIDI Mc' 3 rb MECHANICAL PERMIT APPLICATION FORMgf-376, c- 3 Information Worksheet JOB STREET ADDRESS: • .-34//0 D k .7T�i aez-k p .5555 CITY/STATE/ZIP: `» ifa,ii'7 `j, J,4- PARCEL NUMBER: OWNER: Ri Gh2 rd -TVA /2- PHONE NUMBER: 2 (- 8 YC / MAILING ADDRESS. (Street) (City/State) CONTRACTOR: AIRE VALLEY HEATING & cooling LICENSE NUMBER: AIREVHI1410H PHONE NUMBER: 924-0018 MAILING ADDRESS. N. 521 Ella Rd. Spokane, WA 99212 (Zip) DESCRIPTION (Street) (City/State) MECHANICAL WORKSHEET/FEE SCHEDULE ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) WOc0DSTOVF.INSERT GAS WATER HEATER .................................................................................................................. . • GAS: EQUIPMENT<<100,000 BTU (INCLUDES GAS EQUIPMENT +100,000 BTU DUCTWORK) GAS PIPING (EA OUTL BOILER/REFRIG 1-100M BTU BOILER/REFRIG 501-1,000M BTU BOILERIREI=RIG 1,0001 1,750M BTU<: ;<`' <` BOILER/REFRIG +1,750M BTU HEAT PUMIP &:AIR.CONDITIONER 0 ........ HEAT PUMP & AIR CONDITIONER 3-15 TONS HEAT 'UMP AIS CON ITIONER 1 .. 0 TOMS HEAT PUMP & AIR CONDITIONER 30-50 TONS HEAT PUMP AIR CONDITIONER +50 TONS VENTILATING FANS ..::.:...:.:.:..:.......... TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) CLOTHES DRYER GAS LOG MISGELt ANEOUS (NOT COVERED'ELSEWHE UNLISTED GAS APPLIANCE <400,000 BTU ............................................................................................ ULINSTED'GAS APPLIANCE >400,000 BTU USED APPLIANCE <400,000 BTU USED APPLIANCE >400,000 BTU AIR HANDLER <10,000 CFM .................................................................................................................. • AIR: HANDLER:>10,000 NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE 4:9-6am (Zip) NUMBER OF UNITS X EACH UNIT = AMOUNT x 10.00 = x 25.00 = x 10.00 = x 12.00 = x15.00 = 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 = x35.00 = 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 = / /0- vc.) (ci , v0 ..2., -2 .OJ • • • SUBTOTAL $ c21/- O 0 PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE =$ 1I 9.00 Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675