1992, 05-01 Permit App: 92002987 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: .3V / Y S . /A/ 2 TSS Gam,
CITY/STATE/ZIP: ,S)OOk ft.r (.,Jjj PARCEL NUMBER:
OWNER: k `ja, /�� / a 3 u ra PHONE NUMBER: 90Zy- 4? 3 0
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
DESCRIPTION
(Street)
(City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVE/INBERT.
GAS WATER HEATER
GAS' EQUIPMENT <100000 BTU (INCLUDES
GAS EQUIPMENT +100,000 BTU DUCTWORK)
...............................
GAS. PIPING (EAOUTLET)
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG:101--5! 0M BTU
BOILER/REFRIG 501-1.000M BTU
........................ .
BOILER/RREFRIG1,0001-1,750M BTU
BOILER/REFRIG +1,750M BTU
HEAT PUMP & AIR CONDITIi NER;0-3 TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT PUMP & AIH CONDITIONER 15 30 TUNS
.......::.............:.:............:...............:.:...........:.:............::..:...........:.:...........:.
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT PUMP & AIR CONDITIONER +50 TONS
VENTILATING FANS
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
.........................
...........................
CLOTHES DRYER
RANGE
GAS LOG
MISCELLANEOUS (NOT COVERED !ELSEWHER;
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTEDGAS APPLIANCE>400,000 BTU
USED APPLIANCE <400,000 BTU
.................................................
USED APPLIANCE>40;0,000BTU
AIR HANDLER <10,000 CFM
AIR; HANDLER:>10,000 `CFM
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
gam
(Zip)
(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 =
x12.00 =
x20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 12.00 =
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 =
/,2'=
/ o.%--
fx
.
•
SUBTOTAL
$ j3,00
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
o
=$ 32',Dv
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675