1992, 02-19 Permit App: 92000870 Gas Log, Piping MECHANICAL PERMIT APPLICATION FORM
Information Worksheet�tKb �/, o+-
6 1
JOB STREET ADDRESS: a 3 02 f .S. Sk, wn r r'� SU/
CITY/STATE/ZIP: Sive)/Ca./tatwit . PARCEL NUMBER:' a--- •?ol.e)
OWNER: Pe us Ala.'n mg.-- PHONE NUMBER:
MAILING ADDRESS:
(Street) (City/State) (Zip)
CONTRACTOR: AIRE VALLEY HEATING & cooling LICENSE NUMBER: AIREVHI1410H
PHONE NUMBER: 924-0018
MAILING ADDRESS: N. 521 Ella Rd. Spokane, WA 99212
(Street) - (City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
DESCRIPTION OF UNITS UNIT =AMOUNT
ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 =
O I�
x 25.00
..... .....
GAS WATER HEATER x 10.00 =
GAS EQUIPMENT<I00,000 I TU (INCLUDES x 12.00 =
GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 =
x 1.00 = /
BOILER/REFRIG 1-100M BTU x 12.00 =
x 20.00 =
BOILER/REFRIG 501-1,000M BTU x 25.00 =
BOILERl1 FIG 0 x 35.00 =
BOILER/REFRIG +1,750M BTU x 60.00 =
,gAT.PUMetirAntoNDrTIoNE*p C140TONS... ... .......;; x 12.00
HEAT PUMP &AIR CONDITIONER 3-15 TONS x 20.00 =
HEAT PUMP.&AIFt.�C3NDIT14NE1�:15 �f�.TONS. : `: :_<�: x 25.00
= •
HEAT PUMP &AIR CONDITIONER 30-50 TONS • x 35.00 =
x 60.00 =
VENTILATING FANS x 10.00 =
0
x 100 =
:.;
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) x 50.00 =
.:;::.p. . I H:::O:..;- r > ><ing `ging ' <`><>:.;..>,>'< >go x10.00 =
CLOTHES DRYER x 10.00 =
x1 _
GAS LOG:.:.::::........................................................................................................ x 10.00 =
/0
MISC LL N OUS SNOT CO EI Er ELS
WH I x 10.00 =
UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 =
ULINST D GAS AI PLIANCE;y400 000 BTU x100.00=
USED APPLIANCE<400,000 BTU x 50.00 =
USED APP IANGE>400,000 BTU x100.00=
AIR HANDLER<10,000 CFM x 12.00 =
AII� AN
�: �<`;• x 15.00
SUBTOTAL $ //
PLUS: PROCESSING FEE +$ 25.00
NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT
FEE DUE =$ ,.3 6.00
SIGNATURE Xod £,thm
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675