1992, 06-09 Permit App: 92004169 Heat PumpMECHANICAL PERMIT APPLICATION FORM °\12N 4 (0 9
Information Worksheet
JOB STREET ADDRESS: S • c 3 O ,=2 a2 CJ e r ; yl 2c1 6 &-/2j
CITY/STATE/ZIP: spbiew[.t> / 14•14 • PARCEL NUMBER:
OWNER: 64A,) /r2OLil/lz-S PHONE NUMBER: 726-S"o2,69
MAILING ADDRESS:,/
(Street) (City/State)
CONTRACTOR: AIRE VALLEY HEATING & coolinct LICENSE NUMBER: AIREVHI1410H
PHONE NUMBER: 924-0018
MAILING ADDRESS: N. 521 Ella Rd. Spokane, WA 99212
(Street) (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
GAS WATER HEATER
GAS EQUIPMENT;<100,000 BTU (INCLUl7ES
GAS EQUIPMENT +100,000 BTU DUCTWORK)
GAS PIPING(EA OUTLET)
BOILER/REFRIG 1-100M BTU
........................... .
B EF> M
BOILER/REFRIG 501-1,000M BTU
••
......................
BOILER/I EEI IG 1,0001. 7`50M BTU...:.
BOILER/REFRIG +1,750M BTU
NEAT, FUME? &.AIt CONDITIONER 0:. 3 TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
:HEATP::UMP & AIR CONDITIONER •I50 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
••ITIONEI +50 TONS
VENTILATING FANS
................................................... .
EVAPORATIVE COOLE,:....;::>
............:..:............:.....:............:::.............:::..............................:..:....................
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
CLOTHES DRYER
GAS LOG
MISCELLANEO(NOT COVEREb ELSEW
UNLISTEDUS
GAS APPLIANCE <400,000 BTU
...............................
ULINSTED GAS APPLIANCE>400,000;BTU
USED APPLIANCE <400,000 BTU
USED APPLIANCE X100,000 BTU
AIR HANDLER <10,000 CFM
AIR HANDLER >10�000
NOTE: MINIMUM PERMIT FEE IS $35.00
(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 =
x 20.00
x 25.00 =
x 35.00 =
x 60.00 =
x12.00=
x 20.00 =
x 25.00 =
x35.00 =
x60.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x10.00 =
x 10.00 =
x10.00 =
x10.00 =
x 10.00 =
x 50.00 =
/
/,ZpO
• •
x100.00 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
SUBTOTAL
$ /02.00
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
_$ 3700
SIGNATURE (0 • &yip
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675