1992, 06-05 Permit App: 92004049 Mechanical Fixtures -3 N MECHANICAL'PERMIT APPLICATION FORM 9D.- 4 0 9 9
L,
o �fl ‘• Information Worksheet Lo-7a 5
JOB STREET ADDRESS: S . 170S- S e e.h or r)
CITY/STATE/ZIP: S oka.n,t7 w/}. PARCEL NUMBER:
OWNER: Pay'rfc ,S'Wee.1� Sa..l*re-tt PHONE NUMBER: ,SJy-'cc2.027
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, 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 =
WOOpS`rovEIIN ERr x 25.00 =
GAS WATER HEATER x 10.00 =
GAS<EQUIPMENT<fi00 000 BTU (INCLUDES / x 12.00 = /04
GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 =
GAS PIPING (EA 4UTC, 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 =
HAAT P IMP &AIR C NDITION R 0- TONS < <' x 12.00 =
HEAT PUMP&AIR CONDITIONER 3-15 TONS x 20.00 =
• HEAT PUMP.&AIR CC NDITIONER 15 30 TONS >>': x 25.00 = •
HEAT PUMP &AIR CONDITIONER 30-50 TONS x 35.00 =
HEAT.PUMP&,AI CON 7ITION R+50 TONS x 60.00 =
VENTILATING FANS x 10.00 =
EVAPORATIV COOLERS x 10.00 =
TYPE I HOOD(PER 12' OR 12' PTN. OF HOOD) x 50.00 =
x 10.00 =
CLOTHES DRYER x 10.00 =
x 10.00 =
GAS LOG x 10.00 =
MISCELLANEOUS(NOTCOVERED ELSEWHERE; x 10.00 =
UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 =
ULINSTED;GAS APPLIANCE 5400,000 BTU` x100.00=
USED APPLIANCE<400,000 BTU x 50.00 =
USED APP IANCE>40i 000 t TU x100.00=
AIR HANDLER<10,000 CFM x 12.00 =
AIF-HANDLER X10,000+CFM x 15.00 =
SUBTOTAL $ /3 °�
PLUS: PROCESSING FEE +$ 25.00
NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT
FEE DUE =$ 3 g.oo
SIGNATURESiL
Q' Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675