1993, 05-14 Permit App: 93003540 Mechanical Fixtures 3- 33-1-1()
MECHANICAL PERMIT APPLICATION FORM / P177
Information Worksheet �/
C/ •
JOB STREET ADDRESS: / r • / c' 1/l r bb
CITY/STATE/ZIP: 16/12 9/0 5 7 PARCEL NUMBER:
OWNER: ,/ e<7: PHONE NUMBER: 9 4'l 67(//
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 =
WOODS►OV 'IINSE t ':.. x 25.00 =
GAS WATER HEATER / x 10.00 = /e Ov
GAS I=QUIPMENT<100,000 BTU(INCLUD S / x 12.00 = / , d()
GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 =
GAS PIPING(EA OUTL x 1.00 = .
BOILER/REFRIG 1-100M BTU x 12.00 =
ROIL /REFRIG 1 0 M BTU x 20.00 =
BOILER/REFRIG 501-1,000M BTU x 25.00 =
SC ILI=f /1 EF IG 1,0001 1, 50M B U x 35.00 =
BOILER/REFRIG +1,750M BTU x 60.00 =
HEAT PUMP AiR gNDITIONER'0 TONS< x 12.00 =
HEAT PUMP &AIR CONDITIONER 3-15 TONS • x 20.00 =
• HEA1`PUMP AIR CONDITIONER 1:5 30'PONS . x 25.00 =
HEAT PUMP &AIR CONDITIONER 30-50 TONS x 35.00 =
HEAT PUMP&AIH CONDITIONER+50 TANS x 60.00 =
VENTILATING FANS x 10.00 =
SVA>50RATIV�CObkr=HS
x 10.00 =
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) x 50.00 =
x 10.00 =
CLOTHES DRYER ) x 10.00 =
t�At�G
x 10.00 =
GAS LOG x 10.00 =
MI C LLAN OUS(NOT COVERED;ELS MERE x 10.00 =
UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 =
ULINST D GAS APPLIANCE>400,000 BTU x100.00=
USED APPLIANCE<400,000 BTU x 50.00 =
USED APPLIANCE>400,000 BTU i'! x100.00=
AIR HANDLER<10,000 CFM x 12.00 =
AII�HANbLEFt>1�,OOQ CPM
x 15.00 =
SUBTOTAL $ ^ '
PLUS: PROCESSING FEE +$ 25.00
NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT
FEE DUE =$ w
SIGNATURE
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675