1992, 07-14 Permit App: 92005204 Mechanical Fixtures MECHANICAL PERMIT APPLICATION FORM
• Information Worksheet
JOB STREET ADDRESS: E . //301- J/7�
CITY/STATE/ZIP: S o q...�A--, C0/4. 9'9' 6. PARCEL NUMBER: / 52-1 .
OWNER: � /7 omeJ' s'%o,G, PHONE NUMBER: 90Z y - a 3
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
x 25.00 =
GAS WATER HEATER x 10.00 = //, �°
GAS EQUIPMENT<100,000 BTU (INCLUDES x 12.00 = 2 ��
GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 =
GAS PIPI:NG (SA QUI ET} 3 x 1.00 = 3
BOILER/REFRIG 1-100M BTU x 12.00 =
x 20.00 =
BOILER/REFRIG 501-1,000M BTU x 25.00 =
BC)ILE III EF fG 1,0001 1, 50M BTU' x 35.00 =
BOILER/REFRIG +1,750M BTU x 60.00 =
HEAT PUMP&;AII CONDITIONER 0--S TONS 1 x 12.00 = / ?
HEAT PUMP &AIR CONDITIONER 3-15 TONS x 20.00 =
HEAT PUMP'&AIR CONDITIONER.15. 9f YONS :::'. x 25.00 = •
HEAT PUMP &AIR CONDITIONER 30-50 TONS x 35.00 =
HEAT PUMP &.AIR CONDITTIONEI +50 TONS ;': x 60.00 =
VENTILATING FANS x 10.00 =
VA O ATIVE COOLERS.. :; `;`: x 10.00 =
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) x 50.00 =
CLOTHES DRYER x 10.00 =
• x 10.00 = • •0 0
GAS LOG.. .. ....... . x 10.00 = /O
MISCELLANEOUS( OT COVERED ELSEWHERa x 10.00 =
UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 =
ULINSTED GAS;APPLIANCE;5400,000 BTU x100.00=
USED APPLIANCE<400,000 BTU x 50.00 =
USED AP LIANCE>4t 0,000 BTU' x100.00=
AIR HANDLER<10,000 CFM x 12.00 =
x 15.00 =
SUBTOTAL $ 4/7 DD
PLUS: PROCESSING FEE +$ 25.00
NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT
FEE DUE = 7(.c�
$
SIGNATUREZ.e.,,e,ci
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675