1993, 02-09 Permit App: 93000731 Water Heater, Piping MECHANICAL PERMIT APPLICATION FORM
9
Information Worksheet 12S-1
JOB STREET ADDRESS: S.'. S 179 -
CITY/STATE/ZIP: 4'62.,, /,r'//L �'I ' PARCEL NUMBER:
OWNER: � �: PHONE NUMBER:
MAILING ADD : N�l% .
(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 =
x 25.00 =
GAS WATER HEATER / x 10.00 = /D 00
GAS EQUIPMENT<1p0,0001 T'U (INCLUDES: x 12.00 =
GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 =
x 1.00 = / 0
BOILER/REFRIG 1-100M BTU x 12.00 =
2
x 000 =
BOILER/REFRIG 501-1,000M BTU x 25.00 =
BOILER/REFRIG 1,4 00 .1,750M BTtx ... <;>>>;> `<`>` ` s . x 35.00 =
BOILER/REFRIG +1,750M BTU x 60.00 =
HtT
x 12.00
.00
HEAT PUMP&AIR CONDITIONER 3-15 TONS x 20.00 = •
.................
•
HEA `PUMP&AIR CONDITI NER 15-30 TONS <> < < x 25.00
HEAT PUMP &AIR CONDITIONER 30-50 TONS • x 35.00 =
..NEAT Pl1Mt?&,Alp;CONI3ITIDNSI�:�5G TONS . . > Y{ ;
x 60.00 =
VENTILATING FANS x 10.00 =
x 10.00 =
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) x 50.00 =
ireAMICHMOUSEEINSEREIgnionineng x10.00 =
CLOTHES DRYER x 10.00 =
..............................:.:....::::::..:....::.::::;:.;:.::.:;:.;:.;:.::.....:.::......::............................::::::::.::.:::::.::
x 10.00 =
GAS LOG x 10.00 =
MI:SCELL.ANEOUS.(NOT COVEREC ELSEWHEfR : :<:'`''.> x 10.00 =
UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 =
ULINSTSD G'AS APPLIANCE 5400,000 8 U ::: x100.00=
USED APPLIANCE<400,000 BTU x 50.00 =
x100.00
AIR HANDLER<10,000 CFM x 12.00 =
x15.00 =
SUBTOTAL $
PLUS: PROCESSING FEE +$ 25.00
NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT
FEE DUE =$
SIGNATURE
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675