1991, 11-13 Permit App: 91007806 Mechanical Fixtures/5L/c{.a07o -
L (4,7, MECHANICAL PERMIT APPLICATION FORM
C. o C t-► 2A ( L. Q_N Information Worksheet
JOB STREET ADDRESS: - . I .-;; . ci
CITY/STATE/ZIP: ,S,9r, 4.4143. Zd Al _ PARCEL NUMBER:
OWNER: kat)_. Svc TS PHONE NUMBER: 9a �' - a2 70 ?
MAILING ADDRESS:
(Street) (City/State)
CONTRACTOR: AIRF V LEY HEATING & Cooling LICENSE NUMBER: ATRFVHT141 nH
PHONE NUMBER: 924-0018
MAILING ADDRESS: N. 521 Ella Rd. Spokane, WA 99212
(Zip)
(Street) (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
VV>; .DS:::.:iV /I
p.0..._.ST� .:NS�R'�..
GAS WATER HEATER
.......................................................................................................................
GAS EQUIPMENT <100,000. B U:(INCL.UDES
GAS EQUIPMENT
.G....A....S.....: +100,000 BTU...
DUCTWORK)
...........................
P N
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG 501-1,000M BTU
''� i::Kli
i OILER/REFR1f
......................................
....................................................................................................................
BOILER/REFRIG +1,750M BTU
HEA` `PUMP::& AIR CONDITIONER ti TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEA 'RUMP AIR ONDITIONER 15 30 TOIJS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT 'UMP & AI CCNDITI SNER +50 TONS
•
VENTILATING FANS
EVAPORATIVE LER .
.......................................................................................................................
.......................................................................................................................
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
CLOTHES DRYER
GAS LOG
Mt cwt .A a us tvOT COVERED ELSEWHE
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED GAS APPLIANG X400,000 I TU
USED APPLIANCE <400,000 BTU
USED APPLIANCE 00,000 B'
,AIR HANDLER <10,000 CFM
••A R HANDLER 10,000 iG
BUiLuiNG & SAFETY
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE (7 0t l(M.
(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 =
x 60.00 =
x 12.00 =
x 20.00 =
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 =
/
/ .2 =-
•
SUBTOTAL
$ /a,00
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ J 7, ®J
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675