1992, 06-11 Permit App: 92004214 Water Heater, Piping MECHANICAL PE.RMI PAPPLICATION FORM G ZL 7
Information Worksheet
JOB STREET ADDRESS: 4 # Y/Y 7 /?;G�
CITY/STATE/ZIP: 11001a, / 2.x/4 , PARCEL NUMBER:
OWNER: Da,Ve. Li) /P c 02, PHONE NUMBER: ?'OZ! - / 7/0`,1,
MAILING ADDRESS:
(Street) (City/State) (Zip)
CONTRACTOR: AIRE VALLEY HEATING & cooling LICENSE NUMBER: AIREVHI1410H
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 =
x 25.00
GAS WATER HEATER / x 10.00 = �-
+GAS EQUIPM NT 1OOb00 BTU(INCLubEs x 12.00 =
GAS EQUIPMENT+100,000 BTU DUCTWORK) X 15.00
GAS piP NG (i A OUt ET X 1.00 =
BOILER/REFRIG 1-100M BTU x 12.00 =
6pil49/RgqliLG.40140(W;Of.`U...;>>:>:<:>:::;><:>>:::>:<:>::>i; >«<�: 2
x 20.00
BOILER/REFRIG 501-1,000M BTU : x 25.00 =
:t�0IL1=RLR>;r=F�IG 1,A001 ,�50M BTU ... .... x 35.00
BOILER/REFRIG +1,750M BTU x 60.00 =
HAAT PUMP'&Ate ONDITIONE 0--3 TONS `': _<<:`> x 12.00 =
HEAT PUMP &AIR CONDITIONER 3-15 TONS x 20.00 =
• H Al PUMP&1f►i CCINDItIO EI '15 TOSS`;:> ; `<`< ' x 25.00 =
HEAT PUMP&AIR CONDITIONER 30-50 TONS x 35.00 =
HAAT PUMP AIR CONDITION i.+5 TONS r n<< x 60.00 =
VENTILATING FANS x 10.00 =
A0S..... .; •
: -. .:.;;..... x 10.00
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) x 50.00 =
SPP�.1).:11-Goomplognmainearnamonsigi....: ... ..... .......:.
x10.00
CLOTHES DRYER X 10.00 =
1 •.00
_ •
0
`:fitN
G x •
GAS LOG x 10.00 =
•M,ISC LLANC JUS(NOT COVE RgD ELSEW 1.R.R x 10.00 =
UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 =
ULINST D GAS A�p[.IAN E>400, 00 BtU
x100.00=
USED APPLIANCE<400,000 BTU x 50.00 =
USED APPLIANCE1t) �000 BTU x100.00=
AIR HANDLER<10,000 CFM x 12.00 =
x 15. 0
C
SUBTOTAL $ //
PLUS: PROCESSING FEE +$ 25.00
•
NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS:TOTAL PERMIT
FEE DUE =$ J C.vo
SIGNATURE zs. 4a,f4i)
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675