1991, 03-29 Permit App: 91001419 Furnace, Piping50E0 -
3/Q2 / (
MECHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: s . 4/D002 i i c \ii .e,.1 k7 h,
CITY/STATE/ZIP:spc/l f 14. 9902O( PARCEL NUMBER:
OWNER: 1, i 7j d ct. D .2.e.7t, y
MAILING ADDRESS: lJ
PHONE NUMBER: 902 y - 3 3 O
(Street)
CONTRACTOR: Aire Valley Heating & Cooling
(City/State) (Zip)
LICENSE NUMBER: AIREVHI1410H
PHONE NUMBER: 924-0018
MAILING ADDRESS: N. 521 Ella Rd. Spokane, WA
(Street)
99216
(City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
OF UNITS UNIT
DESCRIPTION
(Zip)
= AMOUNT
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000 BTU
HEATING EQUIPMENT +100;000 BTU
GAS PIPING (1 - 4 OUTLETS)
GAS PIPING (5 OR MORE. EACH:)
REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP)
REFRIG 101-500M BTU
REFRIG 501-1,000M BTU
REFRIG 1,001-1,750M BTU
REFRIG +1,750M BTU
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
VENTILATING
AIR CONDITIONER 0-3 TONS
AIR CONDITIONER 3-15 TONS _
AIR CONDITIONER 15-30 TONS _
AIR CONDITIONER 30-50 TONS _
AIR CONDITIONER +50 TONS
FANS
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE II HOOD
CLOTHES DRYER
RANGE
GAS LOG
MISCELLANEOUS (NOT COVERED ELSEWHERE)
UNLISTED GAS APPLIANCE <400,000 BTU_
UNLISTED GAS APPLIANCE >400,000 BTU_
USED APPLIANCE <400,000 BTU
USED APPLIANCE >400,000 BTU
AIR HANDLER <10,000 CFM
AIR.HANDLER >10,000 CFM
x$10.00 =
x 25.00 =
x 10.00 =
x 12.00 =
x 15.00 =
x 4.00 =
x 1.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 12.00
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x100.00 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
is
1 00
NOTE: MINIMUM PERMIT
FEE I8 $35.00
fLi Z
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
SIGNATURE
SUBTOTAL
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
$ 38, o