1993, 01-29 Permit App: 93000498 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: 5- / /
CITY/STATE/ZIP: �>A) fr'✓-'' /JJ PARCEL NUMBER:
OWNER: /O /ZI r ii27) /7t t/ PHONE NUMBER: </� _ c_U f
MAILING ADDRESS:
(Zip)
(Street) (City/State)
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)
WOODSTOVEJINSERT .
GAS WATER HEATER
GAS EQUIPMENT <1;0O,000 BTU;(INCLUDES
GAS EQUIPMENT +100,000 BTU DUCTWORK)
GAS PIPING (EAOUTLET)•
BOILER/REFRIG 1-100M BTU
BalLER/REF ...101- SOOM BTU ;
BOILER/REFRIG 501-1,000M BTU
80ii*R/p FRIG 1,Opa1 , oM: ,
BOILER/REFRIG +1,750M BTU
HEAT PUMP & AIR + O.NDITION R 0 TONG
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT PUMP & AIRCONDITICNER15-30YTONS;:<'::
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT PUMP &AIR CONDITIONER:+50 TONS
VENTILATING FANS
EVAPORATIVEICOOLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
'TYP t:..:
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 ETU
AIR HANDLER <10,000 CFM
AIR' HANDLED >1 O,,000 CPM
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
4/
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
- AMOUNT
x 10.00 =
x25.00 =
x10.00 =
x 12.00 =
x 15.00 =
x1.00=
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x12.00 =
x 20.00 =
x25.00 =
x 35.00 =
x 60.00 =
x10.00 =
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 1,--
x
x 15.00 =
/
/G DO
/
/,:C v v'
.Z
g 0v
•
•
•
,
i
SUBTOTAL
$
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
=$ ;'60
4
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675