2004, 05-06 Permit App: BLD-04-04280 Furnace, AC*ohne )�
,•03Ualley
Project Addr-ss'
Owner:
Mailing Addres
Contractor:
Mailing Address:
Sit a
Be1,2 E. • s tr,.t
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):
Spe1 io wr (kat/
City / State
License #: Phone #:
Zip Code
Ci
State
AUTHORIZED SIGNATURE:
Zip Code
DESCRIPTION OF WORK
# OF
UNITS
X
COST
=
TOTAL
AMOUNT
1
FUEL BURNING APPLIANCE
Equal to 0, less than 100,000
1
X
515.00
=
/5-00
2
FUEL BURNING APPLIANCE
More than 100 000
X
519.00
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
5100.00
=
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
515.00
=
8
BOILER/REFRIGERATION
101 - 500M BTU
X
$28.00
=
9
BOILER/REFRIGERATION
501 - 1,000M BTU
X
539.00
=
10
BOILER/REFRIGERATION
1,001 - 1,750M BTU
X
557.00
=
11
BOILER/REFRIGERATION
More than 1,750M BTU •
X
$95.00
=
12
GAS LOG, GAS INSERT, GAS FIREPLACE
- -
X
$10.00
=
13
RANGE
X
$10.00
=
14
DRYER
X
510.00
=
15
FUEL BURNING WATER HEATER
X
$10.00
=
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
519.00
=
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
0-3 TON
/
X
$12.00
=
12'06
26
AIR CONDITIONER
3-15 TON
X
$20.00
=
27
AIR CONDITIONER
15-30 TON
X
525.00 •
_
28
AIR CONDITIONER
30-50 TON
X
$35.00
=
29
AIR CONDITIONER
More than 50 TON
X
560.00
=
30
LPG STORAGE TANK
X
510.00
=
31
WOOD OR PELLET STOVE/INSERT
X
510.00
=
32
WOOD STOVE- FREE STANDING
X
525.00
METHOD OF PAYMENT:
❑ CASH ❑ CHECK ❑ VISA 0 MC
CARD #:
- DATE:
SUBTOTAL
PROCESSING FEE
535.00
EXPIRES.
TOTAL PERMIT FEE DUE:
/
i 2.Do
AUTHORIZED SIGNATURE:
Zip Code