1992, 09-22 Permit App: 92007899 Mechanical Fixtures � W�L� r �' MECHANICAL PERMIT AP=PLICATION FORM �a- ` `1
Sinformation Worksheet
JOB STREET ADDRESS: • ?6/ , /07"
CITY/STATE/ZIP: S/llokcg n¢ PARCEL NUMBER:
OWNER: die. n n _Tivcr h u m PHONE NUMBER: 9„z - /4/69
MAILING ADDRESS: U -
(Street) (City/State) (Zip)
CONTRACTOR: AIRE VALLEY HEATING & Cooling LICENSE NUMBER: ATREvHT141 nH
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 =
WOQDSTOVE/INSERT x 25.00 =
GAS WATER HEATER ( x 10.00 = a,--"-----
GASEQUIPMENT'<100,000 BTu (INCLUDES x 12.00 = X02 °�--
GAS EQUIPMENT +100,000 BTU DUCTWORK) x 15.00 =
GAS PIPING (EA OUTLET) x 1.00 =
`"-2-)---
BOILER/REFRIG 1-100M BTU x 12.00 =
BOILER/REFRIG 101-500M BTU x 20.00 =
BOILER/REFRIG 501-1,000M BTU x 25.00 =
BOILER/REFfRIG 1,0001-1,750M Bir x 35.00 =
BOILER/REFRIG +1,750M BTU x 60.00 =
HEAT f UMP&AIR CONDITIONER r0-3 TONS x 12.00 =
HEAT PUMP &AIR CONDITIONER 3-.15 TONS x 20.00 =
HEAT PUMA$�AIR CONDITIONER 5-30 TONs x 25.00 =
HEAT PUMP &AIR CONDITIONER 30-50 TONS x 35.00 =
HAAT PUMP t . ;1R CONDITIONER +50 TONS x 60.00 =
VENTILATING FANS x 10.00 =
VAPORATIVE C OL RS x 10.00 =
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) x 50.00 =
TYPE II HOOD;.. .<':<>'. .i'<s`c'`< `; `. .:.::>::.:::.. x 10.00 =
CLOTHES DRYER x 10.00 =
RANGE x 10.00 =
:.:::...:. ... . .
GAS LOG x 10.00 =
MISCELLANEOUS•(NOT,COVERED ELSEWHERE; 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 APPLIANCE>400,000 BTU x100.00 =
AIR HANDLER <10,000 CFM x 12.00 =
AIR HANDLER>10,000 CFM x 15.00 =
SUBTOTAL $ 2
PLUS: PROCESSING FEE + $ 25.00
NOTE: MINIMUM PERMIT FEE IS $35.00 EQUALS: TOTAL PERMIT
FEE DUE _$ if 9 0�
SIGNATURE
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675