1992, 04-30 Permit App: 92002935 Heat PumpMECHANICAL PERMIT APPLICATION FORM
Informaticti Worksheet
JOB STREET ADDRESS: S. ,j 8 y I` L D r e7'r-G)
CITY/STATE/ZIP: 3flM dna j G1/4 PARCEL NUMBER:
OWNER: £. n(Ld It co/ PHONE NUMBER: 9,.z y -X%.51 g
MAILING ADDRESS:
qc2
(Street) (City/State)
CONTRACTOR: AIRE VALLEY HEATING & cooling LICENSE NUMBER: AIREVHI1410H
PHONE NUMBER: 924-0018
MAILING ADDRESS: N. 521 Ella Rd. Spokane, WA 99212
DESCRIPTION
(Street)
- (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
....................................................
W D y
GAS WATER HEATER
GAS EQUIPMENT <100,000 RTU (INCLUDES
GAS EQUIPMENT +100,000 BTU DUCTWORK)
GAS PIPING (EA OUTLET)
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG 101.500M
BOILER/REFRIG 501-1,000M BTU
...........
BQ LEwnEPF lc:.i,0001 i,750M STI ' '« '<......
BOILER/REFRIG +1,750M BTU
..................
HEAT RUMP &AIR CONmITIQNER 0 TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT. PUMP AIR CQNnytIQNER 15 O.TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
DITIONEli.+5p.TQNS ..
VENTILATING FANS
VAPORA` NE P.Q..t EF
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
CLOTHES DRYER
GAS LOG
MISCELLANEOUS..(N+OT COVERED EL.SEWHE
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED' GAS APPLIANCE X00,000 BTU
USED APPLIANCE <400,000 BTU
.............................
USED APPLIANCE>40 ,000 B
AIR HANDLER <10,000 CFM
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE ,(ga444,1
(Zip)
(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 =
x60.00 =
x12.00=
/
/0202-
x20.00 =
x25.00 =
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 =
•
SUBTOTAL
$ J at ,00
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
=$ 3'7.00
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675