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1992, 03-19 Permit App: 92001659 Mechanical Fixtures,g55 f- 191E V lam' MECHANICAL PERMIT APPLICATION FORM '� �� 1 - Information Worksheet JOB STREET ADDRESS: //-3 202 1'22 i'5S / D n CITY/STATE/ZIP: c S'iOoMo_na (,c 1 A" . PARCEL NUMBER: OWNER: L a / s4 - /eauPHONE NUMBER: 9.2c,2 - 1 iy MAILING ADDRESS: bs (Dam (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) W00DSTOVE/INSERT GAS WATER HEATER GAS EQUIPMENT <100,000BTU. (INCLUDES GAS EQUIPMENT +100,000 BTU DUCTWORK) GAS PIPING (EA OUTLET) BOILER/REFRIG 1-100M BTU BOILERJREFRIG O1 -500M BTU ..: . BOILER/REFRIG 501-1,000M BTU BOILER/REFRIG 1,0001 1,750M BT;U BOILER/REFRIG +1,750M BTU HEAT PUMP & AIR CONDITIONEI 0-3 TONS; HEAT PUMP & AIR CONDITIONER 3-15 TONS • HEAT PUMP &.AIR CONDITIONER 15.30 TONS; HEAT PUMP & AIR CONDITIONER 30-50 TONS HEAT PUMP & All CONDITIONER:+50TONS 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 ULINSTED GAS:APPLIANCE>400,000 BTU USED APPLIANCE <400,000 BTU ................................... ......... USED APIL' IANCE >40;0,000 ;BTU' AIR HANDLER <10,000 CFM All HANDLER >10,000 CFM NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE (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 = x 12.00 = x20.00 = x 25.00 = x 35.00 = x 60.00 = x 12.00 = x 20.00 = x 25.00 = x35.00 = x 60.00 = x 10.00 = x 10.00 = x 50.00 = x10.00 = 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 / /02" .2--- �2 '� • • SUBTOTAL $ a Y.00 PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE = $ 9,_ vb ,0 Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675