1993, 05-04 Permit App: 93003515 Mechanical Fixturesq3-3 I5
MECHANICAL PERMIT APPLICATION FORM
Information Worksheet
<'
JOB STREET ADDRESS: o 2
CITY/STATE/ZIP: PARCEL NUMBER:
OWNER: o (7 /T
MAILING ADDRESS:
PHONE NUMBER:
L/ S ---J5--3 //
(Street)
CONTRACTOR: AIRE VALLEY HEATING & Cooling
MAILING ADDRESS:
N. 521 Ella Rd.
(City/State)
LICENSE NUMBER: ATREVT4T1 41 nH
PHONE NUMBER: 924-0018
Spokane, WA
99212
(Zip)
(Street)
MECHANICAL WORK
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
�ODSTOVEZINSERT
YVCO. _ .
GAS WATER HEATER
GAS: EQUIPMENT <100,OOO BTU (INCLCIDES
GAS EQUIPMENT +100,000 BTU DUCTWORK)
GAS. P1pING �.. 4JiUTLET)...
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG .101--SOOM',BTU'..:. _« <::.
BOILER/REFRIG 501-1,000M BTU
4o1LEF1/RErRIG i.0O01 ...... A t Tu_..
BOILER/REFRIG +1,750M BTU
HEAD PI IMP AIR +GCINDITIONER'....
HEAT PUMP & AIR CONDITIONER 3-15 TONS
tHE T 1: UMP & \IR.+ ONQI ONER 15 30 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT PUf`IP:& iIR C` NDITIi NER +50 T .,.....
VENTILATING FANS
TYPE 1 HOOD (PER 12' OR 12' PTN. OF HOOD)
CLOTHES DRYER
GAS LOG
MISCELLANEOUS (NOT COVER DELS WHE E
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED GAS APPLIANCEi>400,000 BTU
USED APPLIANCE <400.000 BTU
USED APPLIANCE: 100,o0O BTU>
AIR HANDLER <10,000 CFM
l+ll HANDLER>10,000. CFM
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
(City/State)
(Zip)
"NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
25.00 =
x10.00 =
/0.03
x 12.00 =
x15.00 =
%S'DU
x 1.00 =
,2 , dJ
x 12.00 =
x 20.00 =
x 25.00 =
• .
x 35.00 =
x60.00 =
x 12.00 =
x 20.00 --
x25.00 =
x 25.00
x 35.00 =
x 60.00 =
x10.00 =
x 10.00 =
x 50.00 =
x 10.00 =
x 10.00 ---
x 10.00 =
x
x 10.00 =
x 10.00 =
x 50.00 =
x100.00 ---
x 50.00 =
x
x100.00 =
x12.00 =
x 15.00 =
SUBTOTAL
$ �7d6'
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
,J�, aJ
= $
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675