1992, 10-01 Permit App: 92008273 Mechanical Fixtures C l.� J MECHANICAL PERMIT APPLICATION FORM ! a 3
( Information Worksheet
JOB STREET ADDRESS: 5 5 oZ I F a,S+ )/of-k /CO-7
CITY/STATE/ZIP: SvoWn_c\,.e, l v Pi ' r )- PARCEL NUMBER:
OWNER: R, A Wee Xs PHONE NUMBER: 595 - )(Dq5
MAILING ADDRESS:
(Street) (City/State) (Zip)
CONTRACTOR: AIRE VALLEY HEATING & Cooling LICENSE NUMBER: ATRFVHT141 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 =
x 25.00 =
. .....:.... ::.
GAS WATER HEATER I x 10.00 = /o °C
;GAS EQUIPMENT<10Q,000 BTU ON.Q.( DES I x 12.00 =
GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 =
x 1.00 = a "
BOILER/REFRIG 1-100M BTU x 12.00 =
'SOILESIMIEBIOliii014:00*ET )<;<<>::>>>>'<: :. :`>.. x 20.00 =
BOILER/REFRIG 501-1,000M BTU x 25.00 =
- =
I.I�R/:I�hI RIG:1:°O!A��:.;:.:1:�501�A;STU;:.;:> »< >;«>><:':<'>< < «: x 35.00
X41 : ::�. :x::: .. ::.:::.: . :::.:...:....
BOILER/REFRIG +1,750M BTU x 60.00 =
;HEAT PUMP&AIR CONDITIONER0-3.TONS< . »>>: x12.00 =
HEAT PUMP &AIR CONDITIONER 3-15 TONS x 20.00 =
H> AT PUMP&AIR ONI ITIONE 15 0 TONS x 25.00 =
HEAT PUMP &AIR CONDITIONER 30-50 TONS x 35.00 =
HEAT PUMP !& I ?C NDITION R+5th TONS 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 =
tANG ... ...... x 10.00 =
GAS LOG x 10.00 =
MISGELlAN OUS(N ?T COV RED LSEWHER x 10.00 =
UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 =
ULINS ED GAS APPLIANCE>400,000 BTU x100.00=
USED APPLIANCE<400,000 BTU x 50.00 =
;USED APPLIANCE>400,0MBTU x100.00=
AIR HANDLER<10,000 CFM x 12.00 =
AIR I ANIS R 10,000 CL=M...::.; x 15.00 =
SUBTOTAL $ ay o"
PLUS: PROCESSING FEE +$ 25.00
NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT z7/ o
FEE DUE =$
SIGNATURE
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 Vit✓ 7 0o 7