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1992, 12-14 Permit App: 92010923 Mechanical Fixtures 1452cO( 204 L- 2 7�L L MECHANICAL PERMIT APPLICATION FORM ) OO Z- Information Worksheet JOB STREET ADDRESS: , • 10,6/?V //774 1 ( Z- CITY/STATE/ZIP: ®/C �� PARCEL NUMBER: OWNER: �.� //,e' pe.m b/e.- PHONE NUMBER: 9,z 6 - 3/D 2 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 = x2 = WOt�pST�...�IINS�RT... .. ;:.....: 5 00 GAS WATER HEATER / x 10.00 = / GAS EQUIPMENT<100,000 ETU (INCLUDES / x 12.00 = /2 -- GAS GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 = GAS PIPING(EAGUTLET).......: .. ..... . . ... . . .:::: �_ x 1.00 = ev)-- BOILER/REFRIG 1-100M BTU x 12.00 x 20.00 = BOILER/REFRIG 501-1,000M BTU x 25.00 = ;SQ IutR1ogRR1G:noQ7:<.;�x�:.::. : :: :::: .::::::.. :. :::::: x 35.00 = :: ::::::::::. BOILER/REFRIG +1,750M. BTU x 60.00 = x 12. = MSA'T I�uMP&A1B Ct�Nf�zT1±�N�R.0-5 TANS.`<» `'> > ` : 00 HEAT PUMP&AIR CONDITIONER 3-15 TONS x 20.00 = • x2 .00 = HI~A'T PUMP&ArR CONDITIONER 1.5 ��TANS .... >:>':>;>:.: 5 HEAT PUMP &AIR CONDITIONER 30-50 TONS x 35.00 = HEAT PUMP AIR CONDITIONER+50 TONS : x 60.00 = VENTILATING FANS x 10.00 = x 1 .00 = V :. 0 TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) x 50.00 = 0 x10 0 = CLOTHES DRYER x10.00 = xl .00 = • . ............:... 0 GAS LOG x 10.00 = - MISGELII;AI EOU&(N.7£OVEREP ELSEWHE : x 10.00 = UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 = ULINSTED GAS APPLIANCE>400,000 BTU x100.00= USED APPLIANCE<400,000 BTU x 50.00 = USED AP 'UAN GE>400;000 B"CU:..... ....:.. .: . ..... x100.00= AIR HANDLER<10,000 CFM x 12.00 = 0 40 ;:CSM;.::.;;:: ><::;::«<:>::: <<'»<<:;>'<`:: ::>:::>`<: <;:> <<': x 15.00 = SUBTOTAL $ </ PLUS: PROCESSING FEE +$ 25.00 NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT FEE DUE =$ Y , 0) SIGNATURE I Zita4444 Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675