1992, 12-14 Permit App: 92010912 Mechanical Fixtures1\53x4 I ( i l<0
p,5 MECHANICAL PERMIT APPLICATION FORM
QD"tr.
.10 I fb information Worksheet
JOB STREET ADDRESS: 5��Z�2 S . p0 n dr t
CITY/STATE/ZIP: j6�a�u �� PARCEL NUMBER:
OWNER: ?9U44c. (� i H7a. I7104'7 PHONE NUMBER: % Z 7 - '77i.
MAILING ADDRESS:
012_1(DoiL2
niLN
(Street)
(City/State) (Zip)
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)
:;ca.cwsw.w:;w:a:w.,ara-xenra:•:r::::;:::>:::::.>:;;;;;:::+o:o-::::::::::::;r.::: �:a;zas:
GAS WATER HEATER::::::........
.......................................................
GASEQUIPMENT <100 000 BTU (INGl.UDES
GAS EQUIPMENT +100,000 BTU DUCTWORK)
GAS;PIPING
BOILER/REFRIG 1-100M BTU
............................................................................................
O LI*r REFRJG v 00M BTU ...::..::
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG +1,750M BTU
..............................................................................................
HEAT.PUMP & IR.�Gt7I`II ITI N: R.O-
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEA :PUMP &:AIR CONI ITI1E i.15-30 TQN
HEAT PUMP & AIR CONDITIONER 30-50 TONS
DITIO
CONNER +50 TONS:.:..:
.........................................................................
.......................................... .
VENTILATING FANS
....................................................
EVAPORATIVEO.......:....::....
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
......................................................................................................................
CLOTHES DRYER
GAS LOG
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED.GAS:A►I PLIANCE >400,000 BTU
USED APPLIANCE <400,000 BTU
.............................................................................................................
US D / PI I IAN Iw 001000 STU'
............................................................................................................ :
AIR HANDLER <10,000 CFM
AIR HANDL R< ,0•
00
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
(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 12.00 =
x 20.00 =
x 25.00 =
x35.00 =
x 60.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x35.00 =
x 60.00 =
x 10.00 =
x 10.00 =
x50.00 =
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 =
7,9
/
f� -�-
).______
e:v2- -
•
•
SUBTOTAL
$ .2._[(
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ V /
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675