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