1991, 07-25 Permit App: 91004491 Furnace, PipingMECHANICAL PERE/FT-APPLICATION FRM
Information Worksheet
JOB STREET ADDRESS: S'. c`:Z// /J /O yl
CITY/STATE/ZIP: Sipo%(aPARCEL NUMBER:
OWNER: hi,',Y , I r aTo h ns c, n PHONE NUMBER: 9'c2 R - p2<_5-,(PL3
MAILING ADDRESS:
(Street)
CONTRACTOR: Aire Valley Heating & Cooling
MAILING ADDRESS: N. 521 Ella Rd.
(City/State)
LICENSE NUMBER: AIREVHI141OH
PHONE NUMBER: 924-0018
Spokane, WA. 99212
(zip)
(Street)
(City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE
::.•m•.w:+S:.{'.YSTE?i
MS)
.VEANSERvX{f?vv
GAS WATER HEATER _
geM1-fin: `•'Sx�f�'•-•I• �::�
AS lUlPMENT d i 0O TU ::.N 1 1p1r3 .,::,:::<<�� AXF
vim-...,.....,...................:.qms.................... �............---..................., ..mss:,,?�.:•r.:
GAS EQUIPMENT +100,000 BTU DUCTWORK)
BOILER/REFRIG 1-100M BTU
803:1. > .1 EP1=11G 4500M B7 U OO?: } ?t::. ::
BOILER/REFRIG 501-1,000M BTU
......................:.
BOILER/REFRIG +1,750M BTU
HEAT PUMP AIR C0140.MONEq O -3 TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAD'P MP&AIRCONDITIONER'1.S OTONStY<::>rt
HEAT PUMP & AIR CONDITIONER 30-50 TONS
VENTILATING FANS
::EV?'ij:'•..:? - } iLv'4V\i\44v.,,.�+ti.^:
A.. pOpATIVE.CGOLERS�>?:.:;.::::;.:;:.,.:::.> x ...:.:.:::::::.;..���.„4>?;,.:>
TYPE I HOOD (PER 12' OR 12' PIN.. OF HOOD)
•
CLOTHES DRYER
RANG::'`.=:>'
GAS LOG
nvm{ frry
+:4i 54 :Cvtw.xv' .. {J.v: i}::,`':.:?.:.- .••. �C?•%- h -:4
UNUSTED GAS APPUANCE <400,000 BTU
USED APPUANCE <400,000 BTU
AIR HANDLER <10,000 CFM
W}}+Y 44
5•••••^1.
!. • iCs} .}•?%{$}tfit• r; •,•4:7,31$3.*
NOTE: MINIMUM PERMIT FEE IS $35.00
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x10.00 =
x 25.00 =
x10.00 =
/
x 12.00 _
x 15.00 =
x1.00 =
x 12.00
x20.00 =:
x 25.00 =
x35.00=
x60.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x35.00=
x 60.00 =
x10.00 =
x 10.00 =
x 50.00 =
x 10.00 =
x 10.00 =
x 10.00
x 10.00 as
x 10.00 = $ '
x 50.00 =
x100.00 =
x 50.00 in
x100.00 in
x 12.00 -
x 15.00 =
11.222 --
f
1,3
l
.
,
...s�.
d
SUBTOTAL
$ / 3 s=
PLUS: PROCESSING FEE '
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ nil -0
SIGNATURE Lr/ ,a•v Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675