1992, 08-14 Permit App: 92006440 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: S. 3 '7 C 4' Rte r c C".
CITY/STATE/ZIP: Spoka.A./ «,4- • PARCEL NUMBER:
OWNER: 7r) », Fath rock PHONE NUMBER: 9..26 -.S2S7
(p9\3
MAILING ADDRESS:
(Zip)
(Street) (City/State)
CONTRACTOR: AIRE VALLEY HEATING & Cooling LICENSE NUMBER: ATRF:VHT141014
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/IN:SIRRT
.........:.............:..:.....:..................................:....:..........................................:.
GAS WATER HEATER
GAS' EQUIPMENT <100,000 B;TU (INCLUDES..
.....................:....:..............,..............::.............:............:..:................:...............
GAS EQUIPMENT +100,000 BTU DUCTWORK)
...................................................................................... ...
GASPIPING (EA OUTL •
BOILER/REFRIG 1-100M BTU
...............................
BOILER/ EFRIG 01.5 �M STU'..:...:
BOILER/REFRIG 501-1,000M BTU
BOILtR/REFRIG 1,0001-1•,750M BTU
..................:..........................:.....:..:.::............. .
BOILER/REFRIG +1,750M BTU
HAAT I UMP AI CONDITIONER > 3 TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HAAT PUMP & Ali CONDITIONER •1>5 30 TONS;
HEAT PUMP & AIR CONDITIONER 30-50 TONS
"HEAT PUMP &.AIR CONDITIONEI +50 TONS
VENTILATING FANS
EVAPORATIVE COOLE.R5
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
CLOTHES DRYER
RANGE .
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 >40 ,000 BTU
AIR HANDLER <10,000 CFM
Alts HANDL ER X10,000 CPM
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE "JZ4t nlilyl
(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 =
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 =
/O °-='-
-x12.00
/a=' -t -
02 °_'-
•
SUBTOTAL
$ d2. 1.00
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
=$ if `j,0D
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675