2009, 03-10 Permit App: 09000567 Gas AppliancePermit Center
Spore 11707E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
Community Development www.sookanevaltev.or2
Mechanical Permit Application ❑ Commercial
.0,001F.Valley
PERMIT NUMBER: "��
PERMIT FEE:
3-b
g esidential
SITE ADDRESS: R-'3 it r 4 /A Vi
Building Owner -
Narne: i--Levt_ 1.,_eirude brx_.
Phone: Fax:
Address: i 3 % Y r, H ft- i. hr,
City S p r ezii Z°- UU I I y State: ti; 0
zip: 9 %y7I
_
contractor 4, ` , G 4 ricot 0,01)1
1
'1'Y i' rZ- I,-c1 }/+,4 (_ 4rytt4 I
1
Name:
Fax:
Phone: Qa 7.__. 6
Si Bi,
Address: / y ( i { .l. e c.f.-4x ((La
City' Sr K. (J ie f, State:
Zip• y
License No: gc., ARE 614-0` 0 Ryott ?
City Business Lie:
Contact 1 la .‘4 Reil i,
Name
Phone: , 0 - Z VG C et,/ -
,
DESCRIPTION OF WORK
S OF UNITS
X
COST
= TOTAL AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
X
$12.00
CL
2
FUEL BURNING APPLIANCE
More than 100.000
X
$15.00
3
UNLISTED APPLIANCE (Additional Fee)
Equal to or less than 400,000
X
$50.00
4
UNLISTED APPLIANCE (Additional Fee)
More than 400,000
X
$100.00
5
USED APPLIANCE (WSEC min. AFUE rating)
Equal to or less than 400,000
X
$50.00
6
USED APPLIANCE (WSEC min. AFUE rating)
More than 400,000
X
$100.00
7
BOILER/REFRIGERATION
1 -100M BTU
X
$12.00
8
BOILER/REFRIGERATION
101 - 500M BTU
X
$20.00
9
BOILER/REFRIGERATION
501 - 1,000M BTU
X
$25.00
10
BOILER/REFRIGERATION
1,001 - 1,750M BTU
X
$35.00
11
BOILER/REFRIGERATION
More than 1,750M BTU
X
$60.00
12
GAS LOG, GAS INSERT, GAS FIREPLACE
13
RANGE
14
DRYER
X
$10.00
X
810.00
X
$10.00
15
FUEL BURNING WATER HEATER
X
$10.00
16
MISC. FUEL BURNING APPLIANCE
X
$10.00
17
18
GAS PIPING (each outlet)
DUCT SYSTEMS
X
$1.00
X
$10.00
19
VENTILATING FANS
X
$10.00
20
AIR HANDLER (DOES NOT include ducting)
Equal to or less than 10,000 CFM
X
$12.00
21
AIR HANDLER (DOES NOT include ducting)
Greater than 10,000 CFM
X
$15.00
22
EVAPORATIVE COOLERS
X
$10.00
23
TYPE I HOOD
X
$50.00
24
TYPE II HOOD
X
810.00
25
HEAT PUMP /AIR CONDITIONER
0-3 TON
X
$12.00
26
AIR CONDITIONER
3-15 TON
X
$20.00
27
AIR CONDITIONER
15-30 TON
X
$25.00
28
29
30
AIR CONDITIONER
30-50 TON
X
$35.00
AIR CONDITIONER
More than 50 TON
X
$60.00
LPG STORAGE TANK
X
$10.00
31
WOOD OR PELLET STOVE/INSERT
32
33
WOOD STOVE - FREE STANDING
REPAIR & ADDITIONS
X
$10.00
X
$25.00
X
$15.00
34
35
36
37
VENTILATION SYSTEMS
VENTILATION MECHANICAL. EXHAUST
INCINERATOR - RESIDENCE
INCINERATOR - COMMERCIAL
X
812.00
X
$12.00
X
$19.00
X
822.00
METHOD OF PAYMENT:
(]CASH ❑ CHECK ❑ VISA 0 MC
CARD
AUTHORIZED SIGNATURE:
REVISED 8126105
EXPIRES:
VIN:
SUBTOTAL
PROCESSING FEE
TOTAL PERMIT FEE DUE: