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2004, 06-03 Permit App: BLD-04-04481 Gas Log, Piping
j� Project Add -ss• ‘5)/ S �3f)t>cit-e/i Owner: • / . EOM" Mailing Address: J /L di. MECHANICAL PERMIT APPLICATION City of Spokane Valley Community Development Department BuildingDivision 11707 E. Sprague Avenue, Suite 106 Spokane Valley, WA 99206 Phone: (509) 688-0036; Fax: (509) 688-0037 FOR INSPECTIONS, CALL (509) 688-0054 Permit Use: Phone (Daytime Contact): ZZ-- /r = ``tate Contractor: Mailing Address: (,t-il O.CJ Py License #: Li6iI-/i)' 0(00/ Phone #: i7 AUTHORIZED SIGNATURE: Zip Code DESCRIPTION OF WORK # OF UNITS X COST = TOTAL AMOUNT 1 FUEL BURNING APPLIANCE Equal to or less than 100,000 X $15.00 = 2 FUEL BURNING APPLIANCE More than 100,000 X $19.00 = 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 fess 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 $15.00 = 8 BOILER/REFRIGERATION 101 - 500M BTU X $28.00 = 9 BOILER/REFRIGERATION 501 - 1,000M BTU X $39.00 = 10 BOILER/REFRIGERATION 1,001 - 1,750M BTU X $57.00 = 11 BORER/REFRIGERATION More than 1,750M BTU X $95.00 = 12 GAS LOG, GAS INSERT, GAS FIREPLACE / X $10.00 = / 0 , 0 0 13 RANGE X $10.00 = 14 DRYER X $10.00 = 15 FUEL BURNING WATER HEATER X $10.00 = 16 MISC. FUEL BURNING APPLIANCE X $10.0Q = 17 GAS PIPING (each outlet) / X $1.00 = / /, �. ©C 18 DUCT SYSTEMS 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 $19.00 = 22 EVAPORATIVE COOLERS X $10.00 23 TYPE 1 HOOD X $50.00 = 24 TYPE II HOOD X $10.00 = 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 AIR CONDITIONER 30-50 TON X $35.00 = 29 AIR CONDITIONER More than 50 TON X ' $60.00 = 30 LPG STORAGE TANK X $10.00 = 31 WOOD OR PELLET STOVE INSERT X $10.00 = 32 WOOD STOVE - FREE STANDING X $25.00 = METHOD OF PAYMENT: D CASH 0 CHECK 0 VISA D C CARD #: DATE: SUBTOTAL PROCESSING FEE $35.00 PI TOTAL PERMIT FEE DUE: 4(p- 00 IS` AUTHORIZED SIGNATURE: Zip Code