1991, 10-29 Permit App: 91007300 Furnace, Water Heater MECHANICAL PERMIT„P_PPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: S S y �v . &_/
CITY/STATE/ZIP: ?Di q n.�� (,011 PARCEL NUMBER:
OWNER: Odin n (' Q..nt p L>>r l/ PHONE NUMBER: 902 8` - 7?.#,2 0
MAILING ADDRESS:
(Street) (City/State) (Zip)
CONTRACTOR: AIRE VALLEY HEATING & Cooling LICENSE NUMBER: ATRFVHT141OH
PHONE NUMBER: 924-0018
MAILING ADDRESS: N. 521 Ella Rd. Spokane, WA 99212
(Street) (City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
DESCRIPTION OF UNITS UNIT =AMOUNT
ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 =
WAODSTOV TINS tT. x 25.00 =
GAS WATER HEATER ( x 10.00 = /D °%
GAS' QUIPM NT<100► � 1'U (INCI UDES . x 12.00 = /,2 '°=
GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 =
................................................................................................................... .................. ....
GAS'PIPING ( A OUT ETA .. x 1.00 =
BOILER/REFRIG 1-100M BTU x 12.00 =
801 4 RIG:.1 1-500M X711:... x 20.00 =
BOILER/REFRIG 501-1,000M BTU x 25.00 =
OIL R REFIVIG 1,0001 1, 50M BTU x 35.00 =
BOILER/REFRIG +1,750M BTU x 60.00 =
HEAT PUMP'&AIR CONDITIONER 0.:3TONS ` • x 12.00 =
HEAT PUMP &AIR CONDITIONER 3-15 TONS x 20.00 =
NEAT PUMP&AIR CONDITIONER 15.30 TONS x 25.00 =
HEAT PUMP &AIR CONDITIONER 30-50 TONS x 35.00 =
HAAT PUMP AIR CONDITIONER +50 TONS x 60.00 =
VENTILATING FANS x 10.00 =
...........................................................................................................................................
............ ................. ...... ................................ ........... ........... ..........................
EVAPORATIV> I OOLERS . x 10.00 =
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) x 50.00 =
T1(P II HOO x 10.00 =
CLOTHES DRYER x 10.00 =
RANG.:.. .. �.....:.. '
x10.00 =
GAS LOG x 10.00 =
MISCELLANEOUS (NOTCOVERED ELSEWHERE x 10.00 =
UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 =
Ul INSTED GAS APPLIANCE 5400,000 BTU x100.00 =
USED APPLIANCE<400,000 BTU x 50.00 =
:USEDAPPLIANCE00,000.BTU x100.00 =
AIR HANDLER<10,000 CFM x 12.00 =
Alts HAN I ER>10,000 CFM x 15.00 =
SUBTOTAL $
PLUS: PROCESSING FEE +$ 25.00
NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT
FEE DUE =$ IL(7,00
SIGNATURE di , .•/!ip sgezzoiL/
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675