1992, 06-19 Permit App: 92004531 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM
information Worksheet
JOB STREET ADDRESS:_
CITY/STATE/ZIP: _i am rzr
OWNER: ki y!? //S'/)
MAILING ADDRESS:
(Zip)
�a (-/s3
65,-7R 5
PARCEL NUMBER:
PHONE NUMBER: 9026 - 76 SO
(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)
. OV...��00N0E7.1,}ate
GAS WATER HEATER
GAS EQUIPMENT <100,000 BTI .(INCLUDES
GAS EQUIPMENT +100,000 BTU DUCTWORK)
CAS PIPING:(EA bUTI_ET)•
BOILER/REFRIG 1-100M BTU
OILi p/RS RIG 111-�5n01 7U t yt
BOILER/REFRIG 501-1,000M BTU
BOILS /REF IG °I.,00f l 1 750M STI ;
BOILER/REFRIG +1,750M BTU
HEAT PUMP:&AIRCONb1TICNEF t1 -ti
•
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT:PUMP;&AIH CONDITIONER'15 3(
HEAT PUMP & AIR CONDITIONER 30-50 TONS
:HEAT PUMP AIS +CONDITION 50 TONG
VENTILATING FANS
:E
A.> A TI V
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
:?;;:ixi,< fixei.;.ir •`.::`'.K:`":.:. 'r. ?' .K:?^`�:•a';}'•igx;:s:}nr:J^};r:.;•:•t::`.`:c.;:
viii:•:j':.,?•:••{'F:iry�:i:.YS."'5.:p...;.... },. •.tri :::::!•i}i•::..:t:.,..}. }} .},i4}:,: •:ii �•i}'4:
........:... ...:::...... .
CLOTHES DRYER
::Y.:::: }.:: %IX .:..+} i•:Y::::;.:::::
GAS LOG
MISCELLANEOUS (NOT:COVEREf ELS AfH f1 > ......i
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED GAS APPLIANCE 5400,000 8TU
USED APPLIANCE <400,000 BTU
E<..
US pP' A .
AIR HANDLER <10,000 CFM
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE IE 414 Ata49-)
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
- AMOUNT
x 10.00 -
x25.00
X10.00-
/d"3
x 12.00 -
/ 02. a�-
x 15.00 -
I 2
x 1.00 -
pso_
X 12.00 -
x 20.00 -
x 25.00 -
x 35.00 -
x 60.00 -
x 12.00 -
x20.00 -
x25.00 -
x 35.00 -
x 60.00 -
x 10.00 -
x 10.00 lee
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 -
X100.00 -
x 12.00 -
x15.00 -
SUBTOTAL
$ 025! Oo
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
6'S Y 9.00
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675