1991, 09-17 Permit App: 91005972 Gas Log, PipingMECHANICAL PERMIT APPLICATION FORM
Information Worksheet"`'
JOB STREET ADDRESS: 3 i.23 A /J gip, U IA- )
CITY/STATE/ZIP: Sto/CQ. n e, 1,4 . PARCEL NUMBER:
OWNER: VI C/C j' 1- a u7't 5 a tim PHONE NUMBER:
MAILING ADDRESS:
CONTRACTOR: Aire
(Street)
Valley Heating & Cooling
MAILING ADDRESS: N. 521 Ella Rd.
(City/State)
LICENSE NUMBER: AIREVHI1410H
(Zip)
PHONE NUMBER: 924-0018
Spokane, WA. 99212
DESCRIPTION
(Street)
(City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOQC S 0VEIINSi RV*:
GAS WATER HEATER
{.}:k}nvi:villi.'iv-}i}ii:i}}i:•isv'rev}r••':.v•---ro,vrerrer,}:•}'fi:+:}})
GAS EQUIPMENT +100,000 BTU DUCTWORK)
BOILER/REFRIG 1-100M BTU
��L�p�B4OF IREFt I.G U:l-S.►`O.O.NC' ' >l�l '>4 '.
BOILER/REFRIG 501-1,0110M BTU
'BOIL`° `/I EFRIG` ,00b 4.13 M BT
BOILER/REFRIG +1,75•M BTU
-7.77.7"1:7
IR CONDITIONER 0-3 TONS ' ` ' = "
HEAT PUMP & AIR CONDITIONER 3-15 TONS
}TEAT P IMP &,AI CO 1DITIONER 15.30 TONS >;'
HEAT PUMP & AIR CONDITIONER 30-50 TONS
VENTILATING FANS
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
CLOTHES DRYER
GAS -LOG
UNLISTED GAS APPLIANCE <400,000 BTU
USED APPLIANCE <400',000 BTU
•��., r:...:y .-:% ..x..A.<y.<.;<}ti•rY}r4^c.}:`•2};fG<.i;:rr-.y-7:'}`•:b?{••r>vi
k,-�� �`.::,-:::..n�,�,►..IG�:::••'e�a��Ti.�;'}7c*o-r.'i:..<�z'�r,?z.�'•`S3f`�:a::,b}?i�k4.f3�.
AIR HANDLER <10,000 CFM
rte. W.
NOTE MINIMUM PERMIT FEE IS $35.00
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x 25.00 =
x 10.00 =
x 12.00 =
x 15.00 =
x1.00 =
x 12.00 =
x 20.00 =
x25.00 =
x35.00 =
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 =
x 10.00 =
x10.00 =
x 10.00 =
x10.00 =
x50.00 =
x100.00 =
x 50.00 =
x100.00 =
x12.00 =
x 15.00 =
/
/
/ C
SUBTOTAL
$ /1,, Dc)
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ 31 , CC
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
e0