2006, 09-11 Permit App: 06003619 Mechanical FixturesS ane
Valley
Community Development
Mechanical Permit
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)68E0036 FAX: (509)68g-0037
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Application
❑ Commercial
PERMIT DUMBER. (Q t q
PERMIT FEE: f�
Residential
SITE ADDRESS: 1 3 3 ((a E
Auc • SPo e
Building Owner
Name: - , Phone: Fax:
��r 1.4_,..,I,e 2vF�6$f 6750
Address: n City: , State: C� Zip: 9 C\ 21 b
l - E 3anSPoizo, 9 V�11 c
Contractor'; . ' " i .
Name: Phone: Fax:
Address: City: State: Zip:
License No: City Business Lic:
Contact _ zr._
Name: Phone:
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
/
X
512.00
=
2
FUEL BURNING APPLIANCE
More than 100,000
X
515.00
=
3
UNLISTED APPLIANCE (Additional Fee)
Equal to or Tess than 400,000
X
550.00
=
4
UNLISTED APPLIANCE (Additional Fee)
More than 400,000
X
5100.00
=
5
USED APPLIANCE (WSEC min. AFUE rating)
Equal to or Tess than 400,000
X
550.00
=
6
USED APPLIANCE (WSEC min. AFUE rating)
More than 400,000
X
5100.0D
=
7
BOILER/REFRIGERATION
1 - 10DM BTU
X
512.00
=
B
BOILER/REFRIGERATION
101 - 500M BTU
X
520.00
=
9
BOILER/REFRIGERATION
501 - 1,00DM BTU
X
525.00
=
10
BOILER/REFRIGERATION
1,001 - 1,750M BTU
X
535.00
=
11
BOILER/REFRIGERATION
More than 1,750M BTU
X
560.00
=
12
GAS LOG, GAS INSERT, GAS FIREPLACE
X
510.00
=
13
RANGE
X
510.00
=
14
DRYER
X
510.00
=
15
FUEL BURNING WATER HEATER
X
510.00
=
16
MISC. FUEL BURNING APPLIANCE
X
510.00
=
17
GAS PIPING (each outlet)
/
X
51.00
=
18
DUCT SYSTEMS
(
X
510.00
=
19
VENTILATING FANS
X
$10.00
=
20
AIR HANDLER (DOES NOT include ducting)
Equal to or less than 10,000 CFM
X
512.00
=
21
AIR HANDLER (DOES NOT include ducting)
Greater than 10,000 CFM
X
$15.00
=
22
EVAPORATIVE COOLERS
X
510.00
=
23
TYPE I HOOD
X
550.00
=
24
TYPE II HOOD
X
$10.00
=
25
HEAT PUMP/AIR CONDITIONER
03 TON
X
512.00
=
26
AIR CONDITIONER
3-15 TON
X
520.00
=
27
AIR CONDITIONER
15-30 TON
X
$25.00
=
2B
AIR CONDITIONER
30-50 TON
X
$35.00
=
29
AIR CONDITIONER
More than 50 TON
X
$60.00
=
3D
LPG STORAGE TANK
X
$10.00
=
31
WOOD OR PELLET STOVEJINSERT
X
510.00
=
32
WOOD STOVE - FREE STANDING
X
525.00
=
33
REPAIR & ADDITIONS
X
515.00
=
34
VENTILATION SYSTEMS
X
512.00
=
35
VENTILATION MECHANICAL EXHAUST
/'
X
512.00
=
36
INCINERATOR - RESIDENCE
X
519.00
=
37
INCINERATOR - COMMERCIAL
X
522.00
=
METHOD OF PAYMENT:
DCASH 0 CHECK 0 VISA 0 MC
CARD #.
SUBTOTAL
EXPIRES:
PROCESSING FEE
535.00
VIN:
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
REVISED B26/05