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1992, 11-02 Permit App: 92009628 Mechanical FixturesMECHANICAL JOB STREET ADDRESS: ( / ,2 S 6. CITY/STATE/ZIP: S% ¢/�U�h,- OWNER: r (/ , S) p *(y.4 clad -9(02,a drim62, S PERMIT APPLICATION FORM lD �� Inrormath)n Worksheet 7J% hick/nnom y 3a5 PARCEL NUMBER: 3s -0-3c. )92S\ q ,)-JUn PHONE NUMBER: MAILING ADDRESS: (Street) (City/State) CONTRACTOR: AIRF VALLEY HEATING & cooling LICENSE NUMBER: AIREVHI1410H PHONE NUMBER: 924-0018 MAILING ADDRESS: N. 521 Ella Rd. Spokane, WA 99212 (Zip) DESCRIPTION (Street) (City/State) MECHANICAL WORKSHEET/FEE SCHEDULE ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) GAS WATER HEATER GAS EQUIPMENT<100,000 ETU (INCLUDES: -.. GAS EQUIPMENT+100,000 BTU DUCTWORK) 'GAS.PIPING' (EA.OUTLET) BOILER/REFRIG 1-100M BTU .BOILER/REFRIG'101-500M BTU BOILER/REFRIG 501-1,000M BTU BOILER/REFRIG 1,0001-1,750M BOILER/REFRIG +1,750M BTU HEAT.PUMP &AIR CONDITIONER 043.TONS HEAT PUMP & AIR CONDITIONER 3-15 TONS •:HEAT.PUMPSAIR _OONDITIONER15-30.;TONS_:_ HEAT PUMP & AIR CONDITIONER 30-50 TONS ;HEAT;IP..UMP'& AIR CONDITIONER +50;,TONS.:,;`;;; VENTILATING FANS EVAPORATIVE COOLERS°-.. -. TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) TYPEII: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 >400,000:BTU:^::;,`: AIR HANDLER <10,000 CFM :AIR HANDLER >10,000 CFM - NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE &Y, cg. G/ilj/t (Zip) NUMBER OF UNITS X EACH UNIT = AMOUNT - x 10.00 = x 25.00 = x10.00 = x12.00 = x 12.00 x 15.00 = x 1.00 = x12.00 = x 20.00 = x 25.00 = x 35.00 = x 60.00 = x 12.00 = x 20.00 = x25.00 = x 35.00 = x 60.00 = x 10.00 = x 10.00 = x50.00 = 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 = /p, -2---- /c29 -2- -x c2 07- 2x SUBTOTAL $ 02 i PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL FEE PERMIT DUE =s Vg i Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675