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1992, 10-01 Permit App: 92008285 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM (1,ZInformation Worksheet /„ q 9 "� JOB STREET ADDRESS: I 1 5' 5 EQt s t�u�.► �l i`P ;� ,, co \e ([J i / CITY/STATE/ZIP: aPokckne t,t) cici CCo PARCEL NUMBER: OWNER: t2sc\ Gcoss{Y\a_(1 PHONE NUMBER: MAILING ADDRESS: (Zip) (Street) (City/State) CONTRACTOR: AIRE VALLEY HEATING & Cooling LICENSE NUMBER: ATRFVHT141OH 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) woODSTOVE/INS RT ... GAS WATER HEATER ;GAS EQUIPMENT <100000 BTU (INCLU):ES' GAS EQUIPMENT +100,000 BTU DUCTWORK) GAS PIPING (EA OUTLET) BOILER/REFRIG 1-100M BTU BOILER/REFRIG 101+500M 6T11. BOILER/REFRIG 501-1,000M BTU BOILER/REFRIG 1,0001-1,750M S U...:...... . BOILER/REFRIG +1,750M BTU ............................... HEAT PUMP & AIR CONDITIONER HEAT PUMP & AIR CONDITIONER 3-15 TONS 'HEAT.PUM.P :& AIRCONfITIONER 15-+00 TONS HEAT PUMP & AIR CONDITIONER 30-50 TONS HEAT PUMP & IR CONDITIONER+50' TNS VENTILATING FANS ................................................... EVAPORATIVE COOLERS TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) .........:: CLOTHES DRYER ............................................................. ....... RANGE ; GAS LOG .............................................................................................. 'MISCELLANEOUS(NOTCOVERED ELSEWHERE UNLISTED GAS APPLIANCE <400,000 BTU .............................. ... . ULINSTED.GAS APPLIANCE >400,000 BTU USED APPLIANCE <400,000 BTU ............................................ . USED ;APPLIANCE>400 000 BTU AIR HANDLER <10,000 CFM ................................................. AIR HANDI ER >10,000 CFM. NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE (Zip) NUMBER OF UNITS X EACH UNIT = AMOUNT x 10.00 = x 25.00 = x 10.00 = x 12.00 = x 15.00 = x1.00 = x 12.00 = x 20.00 = x 25.00 = x 35.00 = x 60.00 = x12.00 = x20.00 = x 25.00 = x 35.00 = x 60.00 - x 10.00 = x 10.00 = x 50.00 = x 10.00 = x 10.00 = x10.00 = x 10.00 = x 10.00 = x 50.00 = x100.00 = x 50.00 = x100.00 = x 12.00 = x 15.00 = I 1 °t) / /oo SUBTOTAL $ ) 3 00 PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT(.,oa FEE DUE =$ 3 Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 (1A Lq