1992, 07-29 Permit App: 92005879 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM
Information Worksheet j u .U`I,� �/ / kicv,{iS
p
JOB STREET ADDRESS: 6Se Sr" i . v5-> 227`0
CITY/STATE/ZIP: ,S;POkevyLt.4.v PARCEL NUMBER: i/5l e r • tse --
OWNER: L G D k e 1/ ert0' PHONE NUMBER: 94 -yob.
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
DESCRIPTION
(Street)
(City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
GAS WATER HEATER
CAS EQUIPMENT i00 t)O0 BTU (INCLUDES
GAS EQUIPMENT +100,000 BTU DUCTWORK)
BOILER/REFRIG 1-100M BTU
i.S..:.OIE1RE..:F...:.G.........1<
BOILER/REFRIG 501-..5.:1..0.,0.0.0..M0:.M.S....T...0.......v...>:.<..<...>..<......>..<..;<.:>:: ...`.
....
BTU
BOILER/REFRIG 1 00 ,750M
BOILER/REFRIG +1,750M BTU
HEAT' PUMP & AIR' CONDITI NEI
HEAT PUMP & AIR CONDITIONER 3-15 TONS
NEAT' PUMP & AIRWORK)•
BOILER'15 30 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT UMI' & AIR CONDITICF-.:.:.:...:W_.._ ....
VENTILATING FANS
............................................
VA ORATIVE AUC LERS:.
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
CLOTHES DRYER
GAS LOG
,MISCELLANEOUS {NST CK3� p p CLEW
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED GAS APPLIANCE>400,000 STU
USED APPLIANCE <400,000 BTU
USED APPLIANCE>40O,000 BTU'
AIR HANDLER <10,000 CFM
AIt HANDL 1' ,000 +CSM...:...:•.; •:. `<< ' ` `;
NOTE: MINIMUM PERMIT FEE IS $35.00
(Zip)
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 -
x25.00 s
x 10.00 =
x12.00=
%
ld '=
l
/,Z°LIB:-
x 15.00 =
x 1.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x35.00 =
x60.00=
x 12.00 =
x20.00=
x 25.00 a
x35.00 =
x 60.00 =
x 10.00 .
x 10.00 =
x 50.00 =
x 10.00 =
x 10.00 =
X 10.00 =•
x10.00 =
X 10.00 =
x 50.00 =
x100.00 = '
x 50.00 =
_
0.2- o%
•
•
•
x100.00 =
x12.00 =
x 15.00 ••
SUBTOTAL
$ .2'i, od
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
=$ Y9.19°
SIGNATUREQ►,
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675