1993, 05-14 Permit App: 93003537 AC 3--36',
MECHANICAL PERMIT APPLICATION FORM */017
( 7
InformationnJWorksheet
JOB STREET ADDRESS: c]c C) 'WOocX C. /4-rC) k.GQ
CITY/STATE/ZIP: C. 30(-14/1-e.-d``r-C/-�'1� , CJA 9.9,a0 p PARCEL NUMBER:
OWNER: _)O1,I/1 111 f3ei✓1 e_ 1 PHONE NUMBER:
MAILING ADDRESS:
(Street) (City/State) (Zip)
CONTRACTOR: AIRE VALLEY HEATING & Cooling LICENSE NUMBER: ATRF.VHT141OH
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 =
I
WOODS:+"OVEIINSER' ' x 25.00 =
GAS WATER HEATER x 10.00 =
GAS EQUIPMENT<100,000 BTU(INCLUDES x 12.00 =
GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 =
GAS PIPING(EA OUTS E 1') x 1.00 =
BOILER/REFRIG 1-100M BTU x 12.00 =
BOILER/REFRIG 101-5OOM.BTU . ::< > '':.... : :.... ..:< x 20.00 =
BOILER/REFRIG 501-1,000M BTU x 25.00 =
B LI=R/REP IIG 1,0001 1, 50M BTU x 35.00 =
BOILER/REFRIG +1,750M BTU x 60.00 =
HEAT UMP&AIR OONDITIONER 0 TANS t x 12.00 = l a
HEAT PUMP &AIR CONDITIONER 3-15 TONS x 20.00 =
HEAT PUMP.&AIR CONDITIONER>15 30 TONS< ;`' x 25.00 = •
HEAT PUMP &AIR CONDITIONER 30-50 TONS x 35.00 =
NEAT PUMP &AIR CNDITIONER+50 TONS x 60.00 =
VENTILATING FANS x 10.00 =
EVAPORATIVE 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 =
FLANGE x 10.00 =
GAS LOG x 10.00 =
MISCELLANEOUS.(NOT COVERED ELSEWHERE x 10.00 =
UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 =
ULINSTED GAS APPLIANCE>400 000 B1 U x100.00=
USED APPLIANCE<400,000 BTU x 50.00 =
USED APPLIANCE 00,000 BTU x100.00=
AIR HANDLER<10,000 CFM x 12.00 =
AIt HANbLI=R>1 hOOQ CPM;:. .. x 15.00 =
SUBTOTAL $ l02
PLUS: PROCESSING FEE +$ 25.00
NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT
FEE DUE =$ 3' •00
SIGNATURE / ,eG�y" _
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675