1991, 08-19 Permit App 91005116 FurnaceMECHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: /j 9./
CITY/STATE/ZIP: S }�/��� f el.-) 4
l/
MAILING ADDRESS:
OWNER:
CONTRACTOR: Aire
ay,i) v,e--
PARCEL NUMBER:
PHONE NUMBER:
(Street)
Valley Heating & Cooling
MAILING ADDRESS: N. 521 Ella Rd.
(Street)
MECHANICAL WORK
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
GAS WATER HEATER
vASlafi.ETili
Ali+*..... ..:..r.....:
GAS EQUIPMENT +100,000 BTU DUCTWORK)
BOILER/REFRIG 1-100M BTU
rx� WMn}:. --r-y//��::tt.�rr..vy-�:�aY.r. rt•: •.:.. ti:492J.::
Miatagga
BOILER/REFRIG 501-1,000M BTU
s...,,yr ,�,�r r,�:.,Yrw ^ �:•rhew+.u�{Y • , ::.rv:; q :. �;-..o� �,�r..,p,#�.
�/01 :{ � .G 1I.+,J.47; 'R' i V M:. r:}:; :.:. } ::: 'i{:r:: >}.=
:!^3�.'h�.,•�r�F. �'�:.,.•.•:���::.Wr,ir,,..,•::..•�-3-f.::.,�:A�h�:.... ... r.:�,r�.<3:':�w=c•:..::;.'....: •::: ri;:>: � ic: r•"•{:2::
BOILER/REFRIG +1 ,750M BTU
H A ` PUMI tRpoNo o I N ONS ......: <
HEAT PUMP & AIR CONDITIONER 3-15 TONS
H M , 4PITIQNE 5. 30 TC?• NI,S„i
HEAT PUMP & AIR CONDITIONER 30-50 TONS
w.•r{Sir.•v.w: Ir.• ::W { {::fty!7'4!!•.^
HF ) UMP All 'CONDITIONER +5 TONS v :;...-.:
VENTILATING FANS
COOL Rs :'.:.;•,<..:::}>,v}
• r-..ry � .:. .+.4.: n :,.....vfr .-.:Si-: '•..:r r�::%i:f.r}
TYPE HOODn(PER 12' OR 12' PTN. OF HOOD)
00004
CLOTHES DRYER
GAS LOG
{{.w. Syr- I 7:1-01$70WW
,,Y.�,[N�
UNUST_ED GAS APPLIANCE <400,000 BTU
USED APPUAN_CE <400.000 BTU •
AIR HANDLER <10,000 CFM •
rgammoursoitic:
NOTE MINIMUM PERMIT FEE IS $35.00
SIGNATURE ig--C,itt Z&iJim
(City/State)
LICENSE NUMBER: AIREVHI1410H
PHONE NUMBER: 924-0018
Spokane, WA.
(City/State)
(Zip)
99212
(ZiP)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x 25.00 =
x 10.00 =
-
/
x12.00=
/,2 ®�°
x 15.00 =
x 1.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 10.00 =
Y.;
K.
x10.00=
x 50.00 =
x100.00 =
x 50.00 =
x100.00 =
x 12.00 =
x15.00 =
SUBTOTAL
$ J2- . ^r
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
=$ 37.40
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675