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1992, 06-05 Permit App: 92004042 Mechanical Fixtures MECHANICAL PERMIT APPLICATION FORM r" Information Worksheet w lab JOB STREET ADDRESS: I e2. �S O ' 1j74 /�"/ OWNERCITY/STATE/ZIP: ��©l JQ�Ie� �tJJ'¢ , PARCEL PHONE NUMBER:NUMBER: 9�,2(p . s S 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 WOODaTQVE/'�NSIpT ::; GAS WATER HEATER / x 10.00 = /Q 's- GAS EQUIPMENT<I 00,0001BTU (INCLUDES x 12.00 = GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 = 02- x 1.00 = e2 BOILER/REFRIG 1-100M BTU x 12.00 = x 20.00 = BOILER/REFRIG 501-1,000M BTU x 25.00 = BQILER/REP IG 1,0001 a.,750M B>I U ''::;:; x 35.00 = BOILER/REFRIG +1,750M BTU x 60.00 = d 0 x 12.00 = /02 /- HEAT PUMP &AIR CONDITIONER 3-15 TONS x 20.00 = • HEAT PUMP &AIR CONDITIONER 5.30 TONS '::.:'>'::> :�: x 25.00 = • HEAT PUMP &AIR CONDITIONER 30-50 TONS x 35.00 = HEAT PUMP &AIR CONDITIONER;+50 TON5 x 60.00 = VENTILATING FANS x 10.00 = x 10.00 = TYPE I HOOD(PER 12' OR 12' PTN. OF HOOD) x 50.00 = x 10.00 = CLOTHES DRYER x 10.00 = x100 0 = • GAS LOG x 10.00 = MISCE� I AN OUS(NOT COVERED ELSEWHERE x 10.00 = UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 = ULIN5T p GAS:APPLIANC <>400 000 BTU x100.00= USED APPLIANCE<400,000 BTU x 50.00 = USED AI PLIANCE 00,000 BTU x100.00= AIR HANDLER<10,000 CFM x 12.00 = Alts HANI LEt 10,000 QPM:: x 15.00 = SUBTOTAL , $ ..2y.DO PLUS: PROCESSING FEE +$ 25.00 NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT FEE DUE =$ L7 DO SIGNATURE4 L J Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675