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1992, 10-26 Permit App: 92009285 Mechanical Fixturesv`h cia)c9 MECHANICAL PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: 35 /oZ S. Me l i Ssc, 1 CITY/STATE/ZIP: Sljv/'d�n 2d4 OWNER: /L/e d Pan -tai )- PARCEL NUMBER: PHONE NUMBER: 7.2/ - 02,,2/ MAILING ADDRESS: (Street) (City/State) CONTRACTOR: AIRE VALLEY HEATING & Cooling LICENSE NUMBER: ATRFVFTT141 OH PHONE NUMBER: 924-0018 MAILING ADDRESS: N. 521 Ella Rd. (ZiP) Spokane, WA 99212 DESCRIPTION (Street) (City/State) MECHANICAL WORKSHEET/FEE SCHEDULE ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) GAS WATER HEATER:::::::....................................................... GAS EQU!PM NT <100,000 BTU (INCLUDES GAS EQUIPMENT +100,000 BTU DUCTWORK) BOILER/REFRIG 1-100M BTU BOILER/REFRIG 501-1,000M BTU BOILER/REFRIG +1,750M BTU Hr ATP(lMP Arlt CA OITION:EI HEAT PUMP & AIR CONDITIONER 3-15 TONS ;HEAT:PUM & AIR.CONDITIONER HEAT PUMP & AIR CONDITIONER 30-50 TONS HEAT;PUMP & #IR CONDITIONER +50 TONS .. VENTILATING FANS TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) CLOTHES DRYER GAS LOG MISGSLLANEOUS (NOT. COV) RED SEWF ERE UNLISTED GAS APPLIANCE <400,000 BTU ;ULINSTED GAS APPLIANCE>400,000 BTU USED APPLIANCE <400.000 BTU USED APPLIANCE ?400,000 BTU AIR HANDLER <10,000 CFM ........................................................................................................................ NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE ivayLeit, (Zip) NUMBER OF UNITS X EACH UNIT = AMOUNT x 10.00 = x 25.00 = x 10.00 = x12.00 = / 7-2i x 15.00 = x 1.00 =7 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 = °,--- SUBTOTAL $ /2. o° PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE = $ %.? Q '� Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675