1992, 08-31 Permit App: 92006987 Mechanical Fixturesut5a13' it�i. � MECHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: S . 02.6ti
G / % r I, Yl •v=�S
CITY/STATE/ZIP: 6-1,20,eunzi vIQ . PARCEL NUMBER:
OWNER: L; na 4 Tay / o r PHONE NUMBER: 9a 8 - 8 5/a1?'
MAILING ADDRESS:
Z
(Street) (City/State)
CONTRACTOR: AIRE VALLEY HEATING 8, Cooling LICENSE NUMBER: ATRFVHT1411)x
PHONE NUMBER: 924-0018
(Zip)
MAILING ADDRESS: N. 521 Ella Rd. Spokane, WA
99212
(Street) - (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
;WOODSTOVE/INSERT :_ :;I
GAS WATER HEATER
GAS.EQUIPMENT:<i00;000BTU (INCLUDES
GAS EQUIPMENT+100,000 BTU DUCTWORK)
GAS.PIPING(EAOUTLET)` :'
BOILER/REFRIG 1-100M BTU
BOILE11/REFRIG101-00M
BOILER/REFRIG 501-1,000M BTU
BOILER/REF'RIG 1.0001- l,TSOM BTU,::;t : ?rr: :i
BOILER/REFRIG +1,750M BTU
tHEAT:PUMO:l l C iSDITIONE1 0 3;70NS;;:'',;:::.:
HEAT PUMP & AIR CONDITIONER 3-15 TONS
€HEAtPUMP.. &AIR.CONDITIONER 154304TONS:.°:':'";.
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT.. PUMP'B AIR:CONDITIONER;+50 TONS
VENTILATING FANS
EVAPORATIVE COOLERS='
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
CLOTHES DRYER
RANGE r:;::;.:::
GAS LOG
MISCELLANEOUS:(NOT COVERED' ELSEWHERE
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED GAS A.PPLIANCE>400,0.00 BTU';
USED APPLIANCE <400,000 BTU
:USE•DAPPLIANCE>400,000 BTU::::
AIR HANDLER <10,000 CFM
'AIR:HANDLER:>10;t)00 CFM_
NOTE: MINIMUM PERMIT FEE IS $35.00
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x 25.00 =
x10.00 =
x12.00 =
x 15.00 =
x 1.00 =
x12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
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 =
x12.00 =
x 15.00 =
/
/p 4'
/
/a
,�
SUBTOTAL
$ „Z y
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ 9 %0.>
SIGNATURE AS/ gauer,
v Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675