1992, 11-25 Permit App: 92010415 Mechanical Fixtures1
1
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MECHANICAL+PERMIT APPLICATION FORM �2-
// Information Workteet I 02.JOB STREET ADDRESS: 7 YO 7 //. in e 2),-)•,?'
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CITY/STATE/ZIP: SIf n.c PARCEL NUMBER:
OWNER: )22ike_ /7/2rP/tS PHONE NUMBER: 9.26-.2,Seti?
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
(Zip)
(Street) - (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVEIINSERT::
GAS WATER HEATER
:GAS EQUIPMENT<I00,000.BTU (INCLUDES
GAS EQUIPMENT+100,000 BTU DUCTWORK)
GAS PIPING„(EA OUTLET)';;'`
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG :'101. OOM'BTtJ. ;:
BOILER/REFRIG 501-1,000M BTU
;BOIILERIREFRIG 1;000141;750M BTU
BOILER/REFRIG +1,750M BTU
HEAT PUMP. &AIR CONDITIONER 0=3.70NS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
• :HEAT PUMP :& AIRCONDITIONER 15-30 TONS:i.:
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT PUMP & AIR, CONDITIONER„+50,TONS ::::
VENTILATING FANS
EVAPORATIVE:COOLERS .: r
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
..............
TYPE II HOOD ;_
CLOTHES DRYER
GAS LOG
.MISCELLANEOUS. (NOT COVERED ELSEWHERE:.:
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED`GAS APPLIANCE >400,000 BTU
USED APPLIANCE <400,000 BTU
USED APPLIANCE>400,000BTU
AIR HANDLER <10,000 CFM
AIR HANDLER>10,000'CFM
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE C
(Zip)
NUMBER
OF UNITS
ELECTRIC/DUCTWORK
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 =
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 =
x10.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x100.00 =
x 50.00 =
x100.00 =
x12.00 =
x 15.00 =
/
/Qi''-'-
7
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02
c2 '2'
SUBTOTAL
$ ,. 2 q "'-
PLUS: PROCESSING FEE
PLUS:
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ V7-5-
9%
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675