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1992, 06-29 Permit App: 92004800 Mechanical Fixtures
tALCkAv.•aoar6be c:(- ggoo o���me- �,,- MECHANNICALPERMIT APPLICATION FORM �aQ L ° Information Workshbet "Pk( S 05 � JOB STREET ADDRESS: // I S .� . fQ ne. s c�.n S 4 lUU CITY/STATE/ZIP: SPo%2rt C u/.{f . PARCEL NUMBER: OWNER: ZC)A n /7/°4 rt -On PHONE NUMBER: %0202 - 7S7'7 MAILING ADDRESS: (Street) (City/State) CONTRACTOR: AIRE VALLEY HEATING S. cooling LICENSE NUMBER: AIREVHI1410H PHONE NUMBER: 924-0018 MAILING ADDRESS: N. 521 Ella Rd. Spokane, WA 99212 (Street) - (City/State) MECHANICAL WORKSHEET/FEE SCHEDULE DESCRIPTION ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) WO0DSTOVE/INSERT ., .._. ;i9._i':;i:'. GAS WATER HEATER GAS; EQUIPMENT <100,000 BT'U (INCLUDES: GAS EQUIPMENT+100,000 BTU DUCTWORK) ;GAS PIPING (EA OUTLET) BOILER/REFRIG 1-100M BTU BOILEFUREFRIG101.,"00M BTU ,- BOILER/REFRIG 501-1,000M BTU BOILERJREFRIG 1,0001-1,750M BTU:..:.:: BOILER/REFRIG +1,750M BTU :HEAT PUMP &AIR CONDITIONER 043 TONST: HEAT PUMP & AIR CONDITIONER 3-15 TONS • HEATPUMP&AIR_CONDITIONER15-30ToNS` HEAT PUMP & AIR CONDITIONER 30-50 TONS HEAT PUMPI&°AIR CONDITIONER +50::TON& VENTILATING FANS EVAPORATIVE COOLERS TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) :TY,PE.II CLOTHES DRYER RANGE, 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 ................. ...... 'AIR HANDLER >10,000 CFM' NOTE: MINIMUM PERMIT FEE IS $35.00 (Zip) (Zip) NUMBER OF UNITS X EACH UNIT = AMOUNT x10.00 = x 25.00 = x10.00 = x 12.00 = x 15.00 = x 1.00 = x 12.00 = X 20.00 = X 25.00 = X 35.00 = X 60.00 = X 12.00 = x20.00 = x25.00 = X 35.00 = x 60.00 = X 10.00 = X 10.00 = x 50.00 = X 10.00 = X 10.00 = x10.00 = X 10.00 = X 10.00 = X 50.00 = X100.00 = x 50.00 = X100.00 = X 12.00 = X 15.00 = / /0 ° - / /0.2. " :3 3i - SUBTOTAL $ PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE =i SIGNATURE/b,447 4Q „i Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675