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1992, 06-11 Permit App: 92004262 Mechanical FixturesLi rL - d ‘-x'IMECHANICAL PERMIT APPLICATION FORM C` - 5 j' Information Worksheet (c1 JOB STREET ADDRESS: . % 6,2-•o )27a h e 77La CITY/STATE/ZIP: OWNER: MI' SCA !V )j a s PARCEL NUMBER: PHONE NUMBER: 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 (Street) (City/State) MECHANICAL WORKSHEET/FEE SCHEDULE DESCRIPTION ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) ;;W40dSTir7, �IINSB.`i' ....:. > ::.. <.'...p•"loirimpopso.1: GAS WATER HEATER GAS EQUIPMENT x100,00,0 STU. (INc UDES GAS EQUIPMENT +100,000 BTU DUCTWORK) OAS PIPINC:I~ •A t UTLBT) ............. ............: . BOILER/REFRIG 1-100M BTU •B : ; . L>*R/REPRIG101--5��M • BOILER/REFRIG 501-1,000M BTU :SOILER/RBPRIG 0001- ,7`50M:B'• TU. BOILER/REFRIG +1,750M BTU NEAT PUMP' & AIR CONDITIONER 0--S' TONS => > <<>> < HEAT PUMP & AIR CONDITIONER 3-15 TONS •:NEAT:PUMP & AIR. CONDITI INE X15 HEAT PUMP & AIR CONDITIONER 30-50 TONS HEAT"PUMP;& AIRCONDITION•ER +50T• ONS VENTILATING FANS :E A.: ATI. y TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) CLOTHES DRYER .::.::,................................... RNG A GASLOG;;>;.;;............................................................................ : MISCBLLANE.pg§ (N07,COVI=RED >*I SEWH ' UNLISTED GAS APPLIANCE <400,000 BTU ULIN$TED GAS APPLIANCE O0,000,0T•U USED APPLIANCE <400,000 BTU USED APPLIANCE X400,000 STU AIR HANDLER <10,000 CFM NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE 4,94/17ari (Zip) (Zip) NUMBER OF UNITS X EACH UNIT = AMOUNT x 10.00 - x 25.00 = / x10.00- 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 = x20.00 = x 25.00 = x 35.00 = x60.00 - 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 = /D'-2- /.2°' a= • • • • . x 50.00 = x100.00 = x 12.00 = x 15.00 - SUBTOTAL $ .2, y, ov PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE _$ yy, Cc) Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675