1992, 11-25 Permit App: 92010411 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM
information Worksheet ,
H2(0/J
JOB STREET ADDRESS: -- /4=2 6 Y 714/7 h -7( 0
CITY/STATE/ZIP: sad PARCEL NUMBER:
OWNER: ? ` GG /'o/no n T PHONE NUMBER: 9-25/ ^ 02rS
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
DESCRIPTION
(Street)
- (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVE/INSEHT
GAS WATER HEATER
GASEQUIPMENT <100000 ETU (INCLUDES
GAS EQUIPMENT +100,000 BTU DUCTWORK)
...............................
GAS' PIPING (EAOUTLET}
BOILER/REFRIG 1-100M BTU
....................................
BOILER/REFRIG l iwO M:.BXU::...:.
BOILER/REFRIG 501-1,000M BTU
BOILER/REFHIG 1,0001
BOILER/REFRI.G +1,750M BTU
...................................
HEA cUMP & AIB +CONDITIONER - TON
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT P JMP &AIR CONDITIONER I5 30 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
.......................................
HEAT PUMP & AIR CONDITIONER 450 TON
VENTILATING FANS
EVAPORATIVE COOL
:....::..:..::..
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
CLOTHES DRYER
GAS LOG
MISCELLANEOUS (NOT COVERED ELSEWHE
UNLISTED GAS APPLIANCE>400
APPLANCE <400,000 BTU
........................................
ULINSTED:GAS ,000 BTU`
USED APPLIANCE <400,000 BTU
USED APPLIANCE>400,000 BTU
AIR HANDLER <10,000 CFM
AIR HANDLER>:10•,00•
.0>C�M:
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
(Zip)
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00
x 25.00 =
x 10.00 =
x12.00 =
x 15.00 =
x 1.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 12.00 =
x 20.00 =
x25.00 =
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 =
/
/Z
•
SUBTOTAL
$ (02,
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ 37r-
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675