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1992, 01-21 Permit App: 92000326 Mechanical Fixtures
31 sIt �ze3 MECHANICAL PERMIT APPLICATION FORM Information ! WorksheetA JOB STREET ADDRESS: .E. ,302o �I/�( ,ll/ . CITY/STATE/ZIP: 926frJ2t , It.r24 PARCEL NUMBER: OWNER: #4,1 7b up nit PHONE NUMBER' SJ1 -.3I r MAILING ADDRESS: (Street) (City/State) (zip) CONTRACTOR: AIRE VALLEY HEATING & cooling LICENSE NUMBER: AIREVHI1410H PHONE NUMBER: 924-0018 MAILING ADDRESS. N. 521 Ella Rd. Spokage_, WA 99212 qz-3ako sciva (Street) (City/State) MECHANICAL WORKSHEET/FEE SCHEDULE DESCRIPTION ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) GAS WATER HEATER y7a GAS EQUIPMENT+100,000 BTU DUCTWORK) ffiljnarteliti BOILER/REFRIG 1-100M BTU AL Cif BOILER/REFRIG 501-1,000M BTU pBOILER/R�EE(FRIG(+1,750M BTU HEAT PUMP & AIR CONDITIONER 3-15 TONS EtiMPAMBligliMITRIDEr HEAT PUMP & AIR CONDITIONER 30-50 TONS 0 ®1 ° T VENTILATING FANSKMATILC .� �....�� i�:9s: gasi3 TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) Err' CLOTHES DRYER f3..- ...... a'w GAS LOG UNLISTED GAS APPLIANCE <400,000 BTU C4Q Iia .44 USED APPLIANCE <400,000 BTU AIRPiPaReir. Ada A1.,.,. HANDLER <10,000 CFM - 'tel EW01 M NOTE: MINIMUM PERMIT FEE IS $35.00 (Zip) NUMBER OF UNITS XEACH UNIT = AMOUNT x 10.00 = x25.00 = x 10.00 = x 12.00 = x 15.00 = x1.00 = x 12.00 = x 20.00 = x 25.00 = x 35.00 = x60.00 = x 12.00 = x20.00 = x25.00= x35.00 = x 60.00 = x 10.00 = x 10.00 = x50.00 = x10.00= .x 10.00 = x 10.00 = x 10.00 = x 10.00 = x 50.00 = x100.00 = x 50.00 = x100.00 = x 12.00 = x 15.00 = / 42 •o / ! f -2 ---- • SUBTOTAL $ / 3 PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE =$ 32,00 SIGNATURE . +11+.9 igar-01, Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675