1992, 01-14 Permit App: 92000227 Mechanical Fixtures1,L251-1 1- lr.5 S_e
,p(f (T1t55'� P"na" 1-.M1=CHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: 4 . // 7 n Se--
CITY/STATE/ZIP:
SCITY/STATE/ZIP: S9ok n c. I (, 1 4 PARCEL NUMBER:
OWNER: al./..1far 1 e- PHONE NUMBER: 90Z S' 7,2 D y
MAILING ADDRE'S:
(Street) (City/State) (Zip)
CONTRACTOR: AIRE VALLEY HEATING & cooling LICENSE NUMBER: AIREVHI1410H
PHONE NUMBER: 924-0018
MAILING ADDRESS: N. 521 Ella Rd.Spokane, WA 99212
Ma -1 tQ'i/
9a-aa7
531 g
(Street) (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
W00DSTOVE)INSERT:: `
GAS WATER HEATER
GAS EQUIPMENT <100,000 BTU (INCLUDES .
GAS EQUIPMENT+100,000 BTU DUCTWORK)
GAS:PIPING (EA OUTLET)
BOILER/REFRIG 1-100M BTU
BOI.LER/REFRIG 101:_50OM BTU.; :"
BOILER/REFRIG 501-1,000M BTU
BQ.ILER/REFRIG 1.0001'-1,750M_BTU `.
BOILER/REFRIG +1,750M BTU
HEATPUMP:B;:AIR:CONpI?IONER0.=3 TONS:°: ':_..°.;_
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT &~AIRCONDITIONER'15�30 _TONS!"i
HEAT PUMP & AIR CONDITIONER 30-50 TONS
'HEAT PUMP.i&'AIR.CONDITIONER_+50 TONS,:
VENTILATING FANS
?EVAPORATI V E;COQ I'.ERS . :
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
CLOTHES DRYER
GAS LOG
MISCELLANEOUS (NOT;COVERED ELSEWHERE:;,:;.';
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTEp _GAS, APPGANOE-i400,000BTU
USED APPLIANCE <400,000 BTU
USED:' APPLIANCE>400,000 BTU - = €:::;::
AIR HANDLER <10,000 CFM
AIR HANDLER;>10,000 CFM
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE arae/ £4W11
(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 =
x12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 12.00 =
x20.00 =
x 25.00 a
x 35.00 =
x 60.00 =
x 10.00 =
x 10.00 •_
x 50.00 =
x 10.00 =
x 10.00 =
x10.00 =
x10.00=
x 10.00 =
x 50.00 =
x100.00 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
/
/0 o°
1/.2 OD
Y
y
Z
ap4_'-
SUBTOTAL
$ % 5r --
PLUS: PROCESSING FEE
PLUS:
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
=$ 7/%
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675