1992, 12-14 Permit App: 92010924 Mechanical Fixtures MECHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: 3 yD V S. v.S'u4d.6w rD )
CITY/STATE/RP: c.jJ°, a /A,',4- PARCEL NUMBER:
OWNER: c/),9414.1 ;( ./7-et ?z 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 =
W000STOV /INS i '.. .. .. x 25.00 =
GAS WATER HEATER / x 10.00 =
GAS EQ UIPMENT<100,100.BTU (INCLUDES f x 12.00 =
GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 =
x 1.00 = 2
BOILER/REFRIG 1-100M BTU x 12.00 =
x 20.00 =
BOILER/REFRIG 501-1,000M BTU x 25.00 =
x35.00
BOILER/REFRIG +1,750M BTU x 60.00 =
H0-ArRU �MP AIR`00N.QI'CI+ONSfi 040 TANS:`;::;::':`';::::ii< �'
� ''
HEAT PUMP&AIR CONDITIONER 3-15 TONS 1 x 12.00 = / -
x 20.00 =
• HEAT',PU;MP&AIRCONDITIONER 5:.30 TONS.., >`„ x 25.00 = • •
HEAT PUMP &AIR CONDITIONER 30-50 TONS x 35.00 =
HEAT PUMP&AIR CONDITIONER+50 TONS x 60.00 =
VENTILATING FANS x 10.00 =
1 0 =
x 00
TYPE I HOOD(PER 12' OR 12' PTN. OF HOOD) x 50.00 =
x10.00 =
CLOTHES DRYER x 10.00 =
x100
0 = •
GAS LOG x 10.00 = •
MISCELLANEOUS.(N:OTCOVERED ELSEWHE E ,,., x 10.00 =
UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 =
UI,INSTED GAS APPLIANCE X400,000 BTU x100.00=
USED APPLIANCE<400,000 BTU x 50.00 =
US D APP IANCE�4t , 00 BTU x100.00=
AIR HANDLER<10,000 CFM x 12.00 =
x 15.00 =
SUBTOTAL $ 3,6/
PLUS: PROCESSING FEE +$ 25.00
NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT
FEE DUE =$ 6
SIGNATURE Xylif,GP/AA
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675