1992, 05-05 Permit App: 92003074 Mechanical Fictures .02_514D.,
a�c1 VL3 �b� cls- 30-74
�� MECHANICAL PERMIT APPLICATION FORM
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Information Worksheet to 5027
JOB STREET ADDRESS: I 117
CITY/STATE/ZIP: SP(-NhO..(1P. WR q4 a 1 l4 PARCEL NUMBER:
OWNER: QLeSb\J v PHONE NUMBER: Cll71a
MAILING ADDRESS: I LI 117 ECiS R'N CAN S(Jok0.ne. Lv'k G g D I (
(Street) (City/State) (Zip)
CONTRACTOR: AIRE VALLEY HEATING & coolinct 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 =
WOODSTOV /I SSRI x 25.00 =
GAS WATER HEATER x 10.00 =
GAS EQUIPMENT<100,000 BTU (INCLUDES x 12.00 = /�, Oo
GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 =
GAS PIP.1NG ( A QUTL x 1.00 = I o u
BOILER/REFRIG 1-100M BTU x 12.00 =
ROILE1 1REFF IG 119.5 M BTU' x 20.00 =
BOILER/REFRIG 501-1,000M BTUx 25.00 =
... ....... ..... .. ..
x 35.00 =
BOILER/REFRIG +1,750M BTU x 60.00 =
...............
H�A
x 12.00 = /
Do
'f'p�lMp�AIR OONI�ITI+4NEI�'O-S-TONS <'` ' : ` ; �
HEAT PUMP&AIR CONDITIONER 3-15 TONS x 20.00 =
Hl=A7 # UMP&A(1 CONnITIONER 15 $0 TONS >:. x 25.00 = .
HEAT PUMP &AIR CONDITIONER 30-50 TONS x 35.00 =
HAAT PUMP &AIS CONDITION I O TONS x 60.00 =
VENTILATING FANS x 10.00 =
x 10.00 =
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) x 50.00 =x 10.00 =
CLOTHES DRYER x 10.00 =
x 10.00
GAS LOG x 10.00 =
MISC LCANE US(NOT COV RED ELS VYH R x 10.00 =
UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 =
ULINS7 b GAS;APP IANCE;>400 000$1'U x100.00=
USED APPLIANCE<400,000 BTU x 50.00 =
USED AP LIANCE>d x,000 BTU: :. x100.00=
AIR HANDLER<10,000 CFM x 12.00 =
Alli HANDLER 10,000 CSM ; x 15.00 =
SUBTOTAL $ 5 00
PLUS: PROCESSING FEE +$ 25.00
NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT o0
FEE DUE =$ 5o
SIGNATURE k,,Zi.A.Lo.e10 )44A.L)-e4
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675