1993, 05-24 Permit App: 93003882 ACMECHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: / ' ��1/�G G /7e/, _47 / ,J
CITY/STATE/ZIP: o /e�77/J, PARCEL NUMBER: `151L4 •�%I�C(
OWNER: 7~ 0 /97 ��/��� PHONE NUMBER: 9, C� >' 725
/L) O0
740
MAILING ADDRESS: ...S/0//1--- 7
(Street)
CONTRACTOR:AIRE VALLEY HEATING
MAILING ADDRESS: 521 N FLT.A ROAD
(Street)
DESCRIPTION
(City/State) (Zip)
LICENSE NUMBER: AIREVHI 1 41 OH
PHONE NUMBER:
SPnxAN.E, WA
(City/State)
MECHANICAL WORK
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVI /INSER•
I<'
GAS WATER HEATER
+GAS EQUIPMENT <100,000 BTU (INCLUDES
GAS EQUIPMENT +100,000 BTU DUCTWORK)
GAS PIPING (EA OUT •ET)
BOILER/REFRIG 1-100M BTU
....................... .
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG 1,0001 1 T`50M Bi u
BOILER/REFRIG +1,750M BTU
HEAT' PUMP. AI CONDITIONED 0--3 TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
• itIOATP.OMOCARpoNompoER' 15 30 T•
ONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT..PUMP &.AIR CONDITIONER +50.TONS:...
VENTILATING FANS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
CLOTHES DRYER
GAS LOG
MISCELLANEOUS (NOT COVERED !ELSEWHFF
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
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 =
x20.00 =
x25.00 =
x35.00 =
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 =
x10.00 =
/
/1.O2
.
-
• •
x 10.00 =
x 10.00 =
x 50.00 =
x100.00 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
SUBTOTAL
$ 42 Orli
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
=$ 3'7:a)
if Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675