1991, 10-08 Permit App: 91006638 Furnace, Piping MECHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: /oZ /d3 0 6, 74'4 , at,
• CITY/STATE/ZIP: S W� 4 ??,-,20(a PARCEL NUMBER:
OWNER: /�D,b e r t cSc- .. )11a4'? w PHONE NUMBER: 9'02
MAILING ADDRESS:
(Street) (City/State) (Zip)
CONTRACTOR:_AIRE VALLEY HEATING & Cooling LICENSE NUMBER: ATRFVHT141014
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 =
. ...:::.:...:....:.;:.;:.........:..:.;::.;;:
x 25.00 =
GAS WATER HEATER x 10.00 =
ISAS EQUIPM N 100,00 BTU(INCLUDES x 12.00 = /a °�-
GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 =
( °"=
x 1.00
BOILER/REFRIG 1-100M BTU x 12.00 =
.. .t�.1 f�A1=...F11.�:.1.�1:-�5��....t� .tl....................... .... ..... ... .........
x 20.00 =
BOILER/REFRIG 501-1,000M BTU::::::::.................................. ......... x 25.00 =
x 35.00 =
BOILER/REFRIG +1,750M BTU x 60.00 =
H /1T PUMP'> A I C NDITIC NEI TANS x 12.00 =
HEAT PUMP&AIR CONDITIONER 3-15 TONS • x 20.00 =
• HEAT.f? M &1 iR CONDITIONER 15..30 TONS: x 25.00 = .
HEAT PUMP &AIR CONDITIONER 30-50 TONS x 35.00 =
H AI'PUMP AIR C NDITION 1 +50 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 =
• ...........................................................................................................................................
x10.00 =
............................................................................................................................................
CLOTHES DRYER x 10.00 =
x10.00 -
GAS LOG x 10.00 -
...........................................................................................................................................
............................................................................................................................................
MI C LLAN O S(NOT COVERED ELS WHERE x 10.00 =
UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 =
ULINSTED GAS A PLIANC 400,00�Bl U x100.00=
USED APPLIANCE<400,000 BTU x 50.00 =
t1SFU ApPffANG��4��,000 8�'U :
x100.00=
AIR HANDLER<10,000 CFM x 12.00 =
AI ANDLER>10,000 CFM x 15.00 =
SUBTOTAL $ /-?
PLUS: PROCESSING FEE +$ 25.00
NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT
FEE DUE _$ 3 g
SIGNATURE &>tif( S;6Z 1
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675