1992, 12-01 Permit App: 92008583 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: I . � 0 _.._ a iC - ,! , C % ±' _ 7 /\f
CITY/STATE/ZIP: st k 1.-.) 41
- -
OWNER: /l� 77 4 I /11714]
MAILING ADDRESS: d
7 yr
� 2 -- i's'3
PARCEL NUMBER: 35/23. -2oe
PHONE NUMBER: s'33- - /199r /9.2r -'7g?
(Street) (City/State)
CONTRACTOR: AIRE VALLEY HEATING & Cooling LICENSE NUMBER: ATRFVHT141 nH
PHONE NUMBER: 924-0018
MAILING ADDRESS: N. 521 Ella Rd.
(Zip)
Spokane, WA 99212
DESCRIPTION
(Street)
(City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
�,:V
TO S
:INOOgS 1w11N..S1�'I<'.�<<<�>><>�:�<°`>'>:`>';`�<<';<��:>'>:
GAS WATER HEATER
GAS EQUIPM NT <100,000 BTU (INCL UDES
GAS EQUIPMENT +100,000 BTU DUCTWORK)
GAS PIPING (EA .OUTL
BOILER/REFRIG 1-100M BTU
BOILER/1 EERIG 101�►504M BTLI'.:..:..<»
BOILER/REFRIG 501-1,000M BTU
,00•01-1 4
BOILER/REFRIG +1,750M BTU
HEAT PUMP & AIR CONDITIONEI'
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT PUMP. &:AIR CONDITIONER•
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT PUMP &,AIR CONDITIONER:+50 TONS
VENTILATING FANS
EVAPORRATIVE:COOLERS
.:....:........ .........
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
O
.......::::
CLOTHES DRYER
TIAN
GAS LOG
MISCELLANEOUS (N07OVERED 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
AIRHANDLER >10,000 CFM:.::
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
- AMOUNT
x 10.00 -
x 25.00 =
x 10.00 =
x 12.00 =
x 15.00 =
x 1.0 0 =
x 12.00 =
x 20.00 =
x 25.00 =
x35.00 =
x 60.00 =
x 12.00 =
x20.00 =
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 =
/,"a
/
/ •-?- -
/
SUBTOTAL
$ /3 -
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
=$ 3 '
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675