1993, 05-25 Permit App: 93003929 Water HeaterMECHANICAL PERMIT APPLICATION FORM
Infomation Worksheet
JOB STREET ADDRESS: U. 39
(v2 q C ��c\�LV (e c J
CITY/STAT IP: ( pd L_ t -)
e i A �1�(4�C4(0 PARCEL NUMBER:
OWNER: tC t/14,( QT ,err -t� C'�J PHONE NUMBER:
MQ
MAILING ADDRESS:
(Street)
CONTRACTOR:AIRE VALLEY HEATING
MAILING ADDRESS:
(City/State)
7,-/z/z,
9((i2's--"?(SThc
(Zip)
LICENSE NUMBER:_aTREVHI 1 41 0H
PHONE NUMBER:
..
• ' A
(Street) (City/State)
MECHANICAL WORK
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
::WOO V
GAS WATER HEATER
GAS EQUIPMENT1 OO,OOO; BTU,(INCLUDES
GAS EQUIPMENT +100,000 BTU DUCTWORK
•GAS PIPING,(EA OUTkET)
BOILER/REFRIG 1-100M BTU
BOILER/REFRiO2101 500M E•
TU
BOILER/REFRIG 501-1,000M BTU
:BOILER/REFRIG 1,0001 1,7 0M RTU'
BOILER/REFRIG +1,750M BTU
HEAT RUMP > AIR QONd1T10NEl, 0 TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
•HEAT PUMP &`AIR C0iIbITIONER;15 .0n'TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT PUMP & AI► OO:NDItIONSR #S0: TONS
VENTILATING FANS
EVAPORATIVECOOLPRS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
CLOTHES DRYER
GAS LOG
MISCELLANEOUS,(NOT COVERED ELSEWHERE
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED GAS APPLIANCE >400,000 ETU•
USED APPLIANCE <400,000 BTU
USED APPLIANCE>400,000 BTU
AIR HANDLER <10,000 CFM
AIR HANDLER >10,000 CPM
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
� AMOUNT
x 10.00 =
x25.00 =
x 10.00 =
(C.).00
x 12.00 =
x 15.00 =
x 1.00 =
x 12.00 =
x20.00 =
x25.00 =
x35.00 =
x60.00 =
x 12.00 =
x 20.00 =
x25.00 =
x35.00 =
x 60.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x 10.00 =
x 10.00 =
x10.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x100.00 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
•
•
• •
SUBTOTAL
$ 1C.0q
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ 35.00
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675