1992, 05-19 Permit App: 92003528 Mechanical Fixturesno�44. o 2 e
JOB STREET ADDRESS:
MECHANICAL PERMIT APPLICATION FORM
Information Worksheet
��- 2 // o /w» d e a- o.0 r;
CITY/STATE/ZIP: . )p%/ex/2e / /VA-- PARCEL NUMBER:
OWNER: in rr r J a %! e. �in)-Tlm
MAILING ADDRESS:
qa-35zir
(Q(Ql l
PHONE NUMBER: 7. 2 7 ,S'3 ,fin
(Street) (City/State)
CONTRACTOR: AIRE VALLEY HEATING & cooling LICENSE NUMBER: AIREVHI141011
PHONE NUMBER: 924-0018
MAILING ADDRESS: N. 521 Ella Rd. Spokane WA 99212
(Zip)
DESCRIPTION
(Street)
- (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
'W000STOVE/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
13OILER/REFRIG•••101-500M.BTU ::
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 CONDITIONER1:15-30 TONS "
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)
TYPE II HOOD,(", •
CLOTHES DRYER
GAS LOG
;MISCELLANEOUS (NOT COVERED 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
FAIR HANDLER '>.10,000 CFM
NOTE: MINIMUM PERMIT FEE IS $35.00
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x 25.00 =
x10.00 =
x 12.00 =
x 15.00 =
x 1.00 =
x
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 =
/
/0 °i
42 O
2
,� 0/-
/
/02 °°°
SUBTOTAL
$ 3 ,eoo
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS' TOTAL PERMIT
FEE DUE
=$ 61 ,00
SIGNATURE S- l(
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675