1991, 11-19 Permit App: 91007979 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: // �� 0C, ,Oc ri d a-/1//Set
CITY/STATE/ZIP: .Sfo/< Q nt.-/ /i t . PARCEL NUMBER:
OWNER:od d sl`4 h PHONE NUMBER:
MAILING ADDRESS:
03KCCIr- No . 5(--t I `I
9a2a-o3f0
(Street) (City/State)
CONTRACTOR: AIRE VALLEY HEATING & Cooling LICENSE NUMBER: ATRFVHT141nH
PHONE NUMBER: 929-0018
MAILING ADDRESS: N. 521 Ella Rd. Spokane, WA 99212
(Zip)
(Street) (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION . _
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVE/I,NSEFtT•;:: `;;::.,';::':.:;:;:.; ::,:.., :.:,,
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/REEFIIG1014OOM BTU
BOILER%REFRIG 501-1,000M BTU
BOILER/REFIgIGI,0001_:1;750M_BT U:;_::::_ :
BOILER/REFRIG +1,750M BTU
HEAT:PUMP &'AIRCONDITIONER'0.=3TONS::.;
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT PUMP &'A1R CONDITIONER 15-3ETONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT pUMp &'AIR;CONDITIONER .+50 TONS
VENTILATING FANS
EVAPORATIVE. COOLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
CLOTHES DRYER
GAS LOG
MISCELtANEOUS.(NOT:COVERED. ELSEWHERE
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED'GAS APP .IANCE>400,000 BTU -
USED APPLIANCE <400,000 BTU
USED:APPLIANCE5400;000:BTU
AIR HANDLER <10,000 CFM
MR HANDLER>10�000;CF.M,,'
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE ,' scfr91
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x10.00 = -
x 25.00 =
X 10.00 =
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 =
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
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 =
-
/�Z,om
/
/,ao
SUBTOTAL
$ /3.o0
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
_$ 3if, co
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675