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1992, 12-08 Permit App: 92010770 Water Heater, PipingMECHANICAL PERMIT APPLICATION FORM z.,_`� - information Worksheet 1 L `c_� (,,, JOB STREET ADDRESS: ) • 900,2 k r ci ,_a. t .i IE) ., `� CITY/STATE/ZIP: ,5;ecyter44.4 PARCEL NUMBER: OWNER: hcch cwk Do 1-0n PHONE NUMBER: % -2 -- .330 MAILING ADDRESS: (Street) (City/State) CONTRACTOR: AIRE VALLEY HEATING & cooling LICENSE NUMBER: AIREVHI1410H PHONE NUMBER: 924-0018 MAILING ADDRESS: N. 521 Ella Rd. Spokane, WA 99212 (Street) (City/State) MECHANICAL WORKSHEET/FEE SCHEDULE DESCRIPTION ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) WOODSTOVEIINSRT• GAS WATER HEATER GAS EQUIPMENT <100,000 BTU (INCLUDES ., GAS EQUIPMENT +100,000 BTU DUCTWORK) GAS PIPING (EA OUT(ET) BOILER/REFRIG 1-100M BTU t30IL1wRIREF=RIG )/]1:r5i10M BTU BOILER/REFRIG 501-1,000M BTU SOILER/REFRIG 1,0001 1,j50M BTU BOILER/REFRIG +1,750M BTU .................................................. HEAT' PUMP ,All CONDITIONE i O TONS HEAT PUMP & AIR CONDITIONER 3-15 TONS NEAT' PUMP &:AIR CONbItIONEp 15-3O TONS >.` HEAT PUMP & AIR CONDITIONER 30-50 TONS HEAT PUMP &. AIR CONDIT IONS, i +50 • VENTILATING FANS EVAPORATIVE CoOLRs:; TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) `rY E 1 00 CLOTHES DRYER ............................................................................. GAS LOG MISCELLANEOUS (NOT COVERED ELSEWHERE! UNLISTED GAS APPLIANCE <400,000 BTU ........................................... ULINSTED.GAS APPLIANCE>400,000 BTU USED APPLIANCE <400,000 BTU USED APPLIANCE >400,o.00 BTU AIR HANDLER <10,000 CFM AIR HANDLEF >10000 CSM NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE -'4./...21 (Zip) (Zip) NUMBER OF UNITS X EACH UNIT . AMOUNT x 10.00 = x 25.00 = x10.00= /0-- x 12.00 = x 15.00 = x 1.00 = x 12.00 = x 20.00 = x 25.00 = x 35.00 = x 60.00 = x 12.00 = x 20.00 = x25.00 = x 35.00 = x60.00 = x 10.00 = x 10.00 = x 50.00 = x 10.00 = x 10.00 = x10.00 = x10.00 = x10.00 = x 50.00 = x100.00 = x 50.00 = x100.00 = ( / -- _ • • • • 4 x12.00 = x 15.00 = SUBTOTAL $ // r -- PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE =$ 3 Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675