1991, 10-08 Permit App: 91006637 Furnace, Piping MECHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: S. 4' 9/ 9 '(fa,41 Mee,r ,/ '/,,
CITY/STATE/ZIP: 3,2o%u-fir. 1. PARCEL NUMBER: d 7'4 1'1.. /`161
OWNER: ,Pa U(' d 1/16_12 nee. PHONE NUMBER: 9oZa- - ?if-302-
MAILING ADDRESS:
(Street) (City/State) (Zip)
CONTRACTOR: AIRE VALLEY HEATING & Cooling LICENSE NUMBER: ATRFVHT141 OH
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 =
GAS EQUIPMENT<10030 BTU(INCLUDES ( x 12.00 = 102
GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 =
. ...... . .:. .. ......
x 1.00 = o�
� �--
BOILER/REFRIG 1-100M BTU x 12.00 =
OJLI f /REP.FRO 1O1-$OOM t `C�1....:::> ::>::::: . ..:..: :: ::>::>: ; x 20.00 =
BOILER/REFRIG 501-1,000M BTU x 25.00 =
... ... .....................
x 35.00 =
BOILER/REFRIG +1,750M BTU x 60.00 =
HAT PUMP&A�R OND1TIONER TONS x 12.00 =
HEAT PUMP&AIR CONDITIONER 3-15 TONS x 20.00 =
NEAT PUM AIR ONDITIONER 1 RC1 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 =
.. . . .......
x 10.00 =
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) x 50.00 =
Y'1p .I,HOOC...........
......................... ..:::::::... ::::.:.::.:::. :: : ::.::::::> : x10.00 =
CLOTHES DRYER x 10.00 =
x 10.00 =
GAS LOG x 10.00 =
;MISCELLANEOUS.(NOT COVERED ELSEWHERE x 10.00 =
UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 =
ULINST D GAS:APPLIANCE>400 000 t TU x100.00=
USED APPLIANCE<400,000 BTU x 50.00 =
USED PPL1ANCI= ,000 BTU x100.00=
AIR HANDLER<10,000 CFM x 12.00 =
x 15.00 = .
SUBTOTAL $ / 3.a)
PLUS: PROCESSING FEE +$ 25.00
NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT
FEE DUE =$ 3 g a a
SIGNATURE Zii,,u( j '
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675