1991, 11-19 Permit App: 91007963 Mechanical Fixtures a\5(--11-1 - 19'yD c11-,,19(Q3
0Q P K15 L to 6MECHANICAL PERMIT APPLICATION FORM
InformationioWorksheet
JOB STREET ADDRESS: // 74 9 7G> 7
CITY/STATE/ZIP: .57o/ d. A�¢. /,✓4 , PARCEL NUMBER:
OWNER: Waj kg,r-t.) ck PHONE NUMBER:
MAILING ADDRESS:
(Street) (City/State) (Zip)
CONTRACTOR: AIRE VALLEY HEATING & Cooling LICENSE NUMBER: ATREVRT14101-1
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 =
iMI :>:::::> ;.
x 25.00
- D .
S
GAS WATER HEATER x 10.00 =
•o
GAS QUIPMENT<t00,000 BT J(INCLUDES x 12.00 =
GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 =
GAS pI1�ING(E�OUTI_ET�
x 1.00 = /
BOILER/REFRIG 1-100M BTU / x 12.00 =
2 .0
x 0 0 =
BOILER/REFRIG 501-1,000M BTU x 25.00 =
v:
x 35.00 =
t3C3�>_ F�II1S>��itG��QQ01 ;�,75p :;'��:::.: :;:.: . ::. :.::::>::;:
BOILER/REFRIG +1,750M BTU x 60.00 =
2 =
HEAT palMl�c}#I�tt"�N>�ITIC�NER�:�7`QIVS.... . ` :' : ><
• x 12.00
HEAT PUMP&AIR CONDITIONER 3-15 TONS x 20.00 =
•x
2 0 =
� ��uM�&Ari�t�»Dttrar����S Sa 7orvs �'
50
HEAT PUMP &AIR CONDITIONER 30-50 TONS x 35.00 =
HEA PUMP J II L IVCJItI NE{ 5th TONS x 60.00 =
VENTILATING FANS x 10.00 =
EVA'URATIVIT � SLSR5 :.<:` »: x 10.00 =
TYPE I HOOD(PER 12' OR 12' PTN. OF HOOD) x 50.00 =
x10.00 =
CLOTHES DRYER x 10.00 =
GAS LOG x 10.00 =
MISCELLAN QUS.(NOT COVERED;ELSEWHERE ;: x 10.00 =
UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 =
UL INSTED GAS AP'LIANCE>400,000 I '(U x100.00=
USED APPLIANCE<400,000 BTU x 50.00 =
US t APPLIANC >4t ,000 BTU x100.00=
AIR HANDLER<10,000 CFM x 12.00 =
x 15.00
SUBTOTAL $ /3.00
PLUS: PROCESSING FEE +$ 25.00
NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT
FEE DUE =$ 3 Voo
SIGNATURE c2 ?, I del i •
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675