1992, 08-31 Permit App: 92007005 Mechanical FixturesQ \-\\ " "k) MECHANICAL PERMIT APPLICATION FORM
6 Si Information Worksheet
l/l � l 2 E.
JOB STREET ADDRESS:
/)7I.0�I% 1 f
CITY/STATE/ZIP: ..PelkutotPARCEL NUMBER:
OWNER: 7 j) r PHONE NUMBER: 9oZY - rpo2 %
MAILING ADDRESS:
(Street)
(City/State)
CONTRACTOR: AIRE VALLEY HEATING & Cooling LICENSE NUMBER: ATRFVHT141 nH
MAILING ADDRESS:
N. 521 Ella Rd.
PHONE NUMBER: 924-0018
(Zip)
Spokane, WA
99212
DESCRIPTION
(Street)
(City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
VE;<:.:;.:.>; <`><> ><>< >`>.:•.: > <«>>><"<«i
�ttNS�l;.. .. .
GAS WATER HEATER
GA > QUIPMENT <100,000 T J (INCLUDES
GAS EQUIPMENT +100,000 BTU DUCTWORK)
BOILER/REFRIG 1-100M BTU
;BAIgER/Rr FRIG>
BOILER/REFRIG 501-1,000M BTU
.....:...........................
ROI R/ F
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT PUMP &AIR CONDITIONER 15 30 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT.PUMP AIA CONDITIONER +50
VENTILATING FANS
EVAPORATIVE COOL
TYPE I HOOD (PER 12OR 12' PTN. OF HOOD)
CLOTHES DRYER
GAS LOG
INI$GELLANFQUS (NOT COVERED EL.SEWHE
UNLISTED GAS APPLIANCE <400,000 BTU
UIINSTEDGAS.APP[IANCE>400,000 BTU
USED APPLIANCE <400,000 BTU
USED APPLIANCE 00,000 BTU.
AIR HANDLER <10,000 CFM
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE £-'k,( j ils
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 =
x12.00 =
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 =
z �---
/
/_
A.�.
SUBTOTAL
$ ,2- y_ eo
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
=$ V 9'.o
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675