1991, 10-08 Permit App: 91006642 Furnace MECHANICAL PERMIT A PLICATION FORM
Information Worksheet
JOB STREET ADDRESS: - P. ,s7 (,✓ a.4 hof led . /
CITY/STATE/ZIP: PARCEL NUMBER: I15"/`t • 2//1!
OWNER: 44,e,e Rai -e r ,c4 PHONE NUMBER: 702 5-3
MAILING ADDRESS:
(Street) (City/State) (Zip)
CONTRACTOR: AIRE VALLEY HEATING & Cooling LICENSE NUMBER: ATRFVHT141 C-I
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 U_ NITS UNIT =AMOUNT
ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 =
,: ,:,.:V�:.:.:,.,•.;:::::. ,..;'< `` < s<' >`_>'<':.':'«< « > <':'<< 'i`> > <'<>>':
x 25.00 =
GAS WATER HEATER x 10.00 =
GAS.::: QUIPMENT dt00,000 BTU(INGLUDES / x 12.00 = a �-
GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 =
x 1.00 =
BOILER/REFRIG 1-100M BTU x 12.00 =
x 20.00 =
BOILER/REFRIG 501-1,000M BTU x 25.00 =
................
x 35.00 =
BOILER/REFRIG +1,750M BTU x 60.00 =
HEATTUM &AAIB CONDITIONE1 3 TONS ': , < • x 12.00 =
HEAT PUMP &AIR CONDITIONER 3-15 TONS x 20.00 =
HAAT PUMP&AI C NDITIONER 15 30 TONS': x 25.00 = •
HEAT PUMP&AIR CONDITIONER 30-50 TONS x 35.00 =
HEAT PUMP&AI NDITI NER X50 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 =
x 1 =0.00
CLOTHES DRYER x 10.00 =
NGS
x1000 =
GAS LOG x 10.00 =
MISC LLANEC US(NOT COVERED:ELSEWHER x 10.00 =
UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 =
ULINST D G IS APPLIANCE>400,000 BTU x100.00=
USED APPLIANCE<400,000 BTU x 50.00 =
USEDAPPLIANC 00,000;BTU x100.00=
AIR HANDLER<10,000 CFM x 12.00 =
All AN x 15.00 = .
SUBTOTAL $ /a
PLUS: PROCESSING FEE +$ 25.00
NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT
FEE DUE =$
SIGNATURE 4i, J/ , ,1.
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675