1992, 09-23 Permit App: 92007994 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: 30 0. S, 211e.), Ga e-7
CITY/STATE/ZIP: �, / ( PARCEL NUMBER:
OWNER: ga )_ Jrrt i'tij PHONE NUMBER: 9.- VSS7
MAILING ADDRESS:
(Street) (City/State)
CONTRACTOR: AIRE VALLEY HEATING & Cooling LICENSE NUMBER: ATRFVRT141 nH
PHONE NUMBER: 924-0018
(Zip)
MAILING ADDRESS: N. 521 Ella Rd. Spokane, WA 99212
DESCRIPTION
(Street)
(City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WQ
::
Qi�ST4.::: VE/1..N...
GAS WATER HEATER
GAS. EQUIpM(INCLUDES ...''
GAS EQUIPMENT +100,000 BTU DUCTWORK)
.............
BOILE.R/REFRIG 1-100M BTU
EQILEA/REFRIG.
BOILER/REFRIG 501-1,000M BTU
i3QI F
BOILER/REFRIG +1,750M BTU
H AT PUMt AINDITION R 0 S TONS:..
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
NEAT PUMP & AI t: CONE ITIONEt +50 TONS.:.::
VENTILATING FANS
RATIV LE
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
CLOTHES DRYER
GAS LOG
MISC LAN OUS (NO'S'•COVERED EI;SEWH
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED GAS APPLIANSE >400,000. BTU
USED APPLIANCE <400,000 BTU
USED APP ,IANCE>4O0,0O0 BTU
AIR HANDLER <10,000 CFM
All HANDLER >1
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
e,
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x 25.00 =
x10.00=
x12.00=
/ di
/a7-'-'----
x 15.00 =
x 1.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x12.00 =
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 =
c2. ?-1--..
•
SUBTOTAL
$ y e-`-•-i-
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
=$ , �-
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675