1992, 10-28 Permit App: 92009428 Mechanical Fixtures Ca-aqPZ6 -_ C'C ' LI
MECHANICAL PERMIT APPLICATION FORM
Information Worksheet 10(05JOB STREET ADDRESS: /y Z" ' 4 ( a,� h9,fA c7-
CITY/STATE/ZIP: , -4zil�/ w-4----- PARCEL NUMBER:
OWNER: Pod- /74).4 lle. PHONE NUMBER: ?02.7 - .,2•:,20,0
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, NA 99212
(Street) (City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
DESCRIPTION OF UNITS UNIT =AMOUNT
ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 =
WOODSTOVE1II ISER ' x 25.00 =
GAS WATER HEATER x 10.00 = /0 '°/
GAS EQUIPMENT<100,00o BTU.(INUD
CLES / x 12.00 = /02-°�-
GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 =
GAS PIPING (EA OUTLET) .3 x 1.00 = j
BOILER/REFRIG 1-100M BTU x 12.00 =
t DILE /REFRI.G 10 -500M BTu >:'>: :< x 20.00 =
BOILER/REFRIG 501-1,000M BTU x 25.00 =
BOILE REFRIG 1,0001 1,750M ETU .. . <.`::.:::: i` x 35.00 =
BOILER/REFRIG +1,750M BTU x 60.00 =
HEA 'PUMP&All CONDITIONER 0- TONS > ` `: / x 12.00 = /�2 °i
HEAT PUMP&AIR CONDITIONER 3-15 TONS x 20.00 =
• HEAT PUMP$LAIR CONDITIONER 15 30 TONS x 25.00 = •
HEAT PUMP &AIR CONDITIONER 30-50 TONS • x 35.00 =
HEAT'PUMP&AIF CONDITIONED.,+50 TONS :,' x 60.00 =
VENTILATING FANS x 10.00 =
EVAPORATIVECOOLERS x 10.00 =
... ..... .... .. .
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) x 50.00 =
TYPE U HOOD x 10.00 =
CLOTHES DRYER x 10.00 =
x 10.00 =
GAS LOG / x 10.00 = p j
MISCELLANEOUS. NOT COVERED ELSEWHERE x 10.00 =
UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 =
ULINSTED GAS APPLIANCE>400 000 BTU x100.00=
USED APPLIANCE<400,000 BTU x 50.00 =
USED APPLIAN:CE>400,000 BTU x100.00=
AIR HANDLER<10,000 CFM x 12.00 =
All HANDLER>10,000.CFM.: x 15.00 =
SUBTOTAL $ y7
PLUS: PROCESSING FEE +$ 25.00
NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT //
FEE DUE =$ 7
SIGNATURE vet, //�,, �--
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Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675