1992, 03-26 Permit App: 92001906 Heat Pump.>
MECHANICAL PERMIT APPLICATION FORM
CC Information Worksheet
JOB STREET ADDRESS: J C)Lt 7-A 2,5-P/ I/ 1n e s
CITY/STATE/ZIP: S.9c/CC-m..# 2/diePARCEL NUMBER:
(
OWNER: i7`tle,ikke.Yrtn PHONE NUMBER: 9-2F-6 Ci
MAILING ADDRESS:
(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)
•WOODSTOVE/INSERT
GAS WATER HEATER
.GAS^EQUIPMENT <100,000: BTU'(INCLUDES
GAS EQUIPMENT+100,000 BTU DUCTWORK)
GAS PIPING (EA:OUTLET)
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG 101-500M 9TU
BOILER/REFRIG 501-1,000M BTU
;BOILER/REFRIG`.1,0001_-1;750M BTU
BOILER/REFRIG +1,750M BTU
HEAT PUMP &'AIR CONDITIONER 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, &AR +
IR CONDITIONE50 TONS°
VENTILATING FANS
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE II HOOD
CLOTHES DRYER
RANGE °.
GAS LOG
MISCELLANEOUS (NOT COVERED ELSEWHERE
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED'GAS' APPLIANCE >46090 BTU
USED APPLIANCE <400,000 BTU
•,USE D APPLIANCE)400,000:BTUI
AIR HANDLER <10,000 CFM
AIR HANDLER>10,000 CFM:
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 =
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 =
/
/.1o0
SUBTOTAL
$ /2.00
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
=$ 37.00
SIGNATURE /la&, nsgaion
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675