1992, 06-09 Permit App: 92004165 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET.ADDRESS: S. 190/ 7 jti40ci h till-
-)hi
ilf
CITY/STATEJZIP: Soo £a/w, !✓4 .
OWNER: Rurlcj
PARCEL NUMBER:
PHONE NUMBER:
H IQS
013(
9,202 - 0 20"3
MAILING ADDRESS:
(Street) (City/State)
CONTRACTOR: AIRE VALLEY HEATING & cooling LICENSE NUMBER: AIREVHI1410H
PHONE NUMBER: 924-0018
MAILING ADDRESS: N. 521 Ella Rd. Spokane, WA 99212
DESCRIPTION
(Street)
(City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
(Zip)
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
GAS WATER HEATER
I P EblP,InASN,tS0, o '4RIK1 E,iJDI<SY::'
GAS EQUIPMENT+100,000 BTU DUCTWORK)
MilliMINWESEMO
BOILER/REFRIG 1-100M BTU
miteimaito
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG +1,750M BTU
#NEA'i' ?i71v p.;&„ [1 tdt ipON
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
u ���.�'1��.>'yy"�''Y� }p+//�� 11r,�,,��Il CI�my,
f o :::w'�.h'..A#ark?L'fw:.o�SQ'�Ra�a'Ga>feSwin'?s'Surs;F`ark"
VENTILATING FANS
VAMATIqtatt
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
..T:..:is...,i�lk�>..:iw^✓'.�ivF:GP.J; �G,:>ni�p
CLOTHES DRYER
GAS LOG
Liamowscr or c .r l
UNLISTED GAS APPLIANCE <400,000 BTU
( L1N5'D SAS„Aflp,41r g.
USED APPLIANCE <400,000 BTU
us r ;' aiA�14 34410 0107
x..,.
AIR HANDLER <10,000 CFM
TIMI•711 107"
X 10.00 IC
x 25.00 =
x 10.00 =
x 12.00 =
x 15.00 =
x 1.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x 10.00 =
x 10.00 =
x10.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x100.00 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
/02 ee-
7a o0
NOTE: MINIMUM PERMIT FEE IS $35.00
SUBTOTAL
PLUS: PROCESSING FEE
$ ? 6, oo
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
=$ /. 60
SIGNATURE IS Sacvtrz-
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675