1993, 04-02 Permit App: 93002051 ACMECHANICAL PERMIT APPLICATION FORM
JOB STREET ADDRESS. _' <7 e%'7 ,
CITY/STATE/ZIP: , 2� 1K/Z ; 1 i' ;
OWNER: > _� �'� ' . x-01Oz? 'r
MAILING ADDRESS:
formation Worksheet i1 i 3 `�
PARCEL NUMBER:
PHONE NUMBER: '? t _ ��
(Street) (City/State)
CONTRACTOR: AIRE VALLEY HEATING & Cooling LICENSE NUMBER: ATRFVHT141 OT -T
PHONE NUMBER: 924-0018
MAILING ADDRESS: N. 521 Ella Rd.
(Zip)
Spokane, WA
99212
DESCRIPTION
(Street)
(City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
'GAS WATER HEATER
GAS EQUIPMENT +100,000 BTU DUCTWORK)
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG 501-1,000M BTU
EQIL R/R F iIG ,0001-1, 0M •TtJ.•
.....
BOILER/REFRIG +1,750M BTU
HEAT 'PNINE AIR Ct NDITION: R.:O.:: ;TONS `<
HEAT PUMP & AIR CONDITIONER 3-15 TONS
€HEATP IM' AIR CONDITIONER 15: 30 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
;HEAT PUMP & AIR CONTIN
DIOE•R +50 TANS..::;:
VENTILATING FANS •
TYPE HOOD (PER 12' OR 12' PTN. OF HOOD)
.......................
CLOTHES DRYER
...........................................................................................................
MISCELL N O:US (NOT OOVE t EWE
UNLISTED GAS APPLIANCE <400,000 BTU
UCINSTED GAS APPI IANCE>400,000 BTU
USED APPLIANCE <400,000 BTU
AIR HANDLER <10,000 CFM
ie:S:�ww>:rw�wr�ic:
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x 25.00 =
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 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
X 60.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x 10.00 =
x10.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x50.00 =
x100.00 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
l{
f.i 0v
SUBTOTAL
$ to700
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ ,-.527.
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675