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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