1993, 04-09 Permit App: 93002323 Mechanical Fixtures\)°- (1'°
MECHANICAL PERMIT APPLICATION FORM
Informations Worksheet
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JOB STREET ADDRESS: l o�� KA\(/ -Z- I ,
CITY/STAT IP:0
OWNER: ` )CC) -1`M C.•'4YCi1
PARCEL NUMBER:
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PHONE NUMBER: (T'r p) -°3 ) 0
MAILING ADDRESS:
(Street) (City/State)
CONTRACTOR: AIRE VALLEY HEATING & Cooling LICENSE NUMBER: ATRFVHT141 DR
PHONE NUMBER: 924-0018
MAILING ADDRESS:
N. 521 Ella Rd.
(ZiP)
Spokane, WA 99212
(Street) (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
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GAS WATER HEATER
GAS EQUIPMENT +100,000 BTU DUCTWORK)
BOILER/REFRIG 1-100M BTU
::...:..:........:.....:..:...:.......:..............::..............:...:.::.....
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG +1,750M BTU
s
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
•r Cr NDITION orvS
VENTILATING FANS
...:.............................................::.............................:::::::....:.........:........
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
CLOTHES DRYER
GAS LOG
:MIC7US (NOT OVERED ELS WH F
UNLISTED GAS APPLIANCE <400,000 BTU
ULiNS ED.GAS At f'LtANCE >400 000:1 TU
USED APPLIANCE <400,000 BTU
..................................................:.........:.......
AIR HANDLER <10,000 CFM
NOTE: MINIMUM PERMIT FEE IS $35.00
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x25.00 =
x 10.00 =
x 12.00 =
x 15.00 =
x 1.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x12.00 =
x20.00 =
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 =
x50.00 =
x100.00 =
x 12.00 =
x 15.00 =
C
(,
/
(,
SUBTOTAL
$ tR -OQ
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ / • DO
SIGNATURE w
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675