2011, 10-04 Permit App: 11003116 Mechaical FixturesstiivrneN,
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
Community Development www.snokanevallev.or2
Mechanical Permit Application IN Commercial
SITE ADDRESS: l l clD .7 6 t -i Pr l�
PERMIT NUMBER 5
PERMIT FEE: - (p
❑ Residential
Building Owner
Name: % Phone: Fax:
� 4115 L,c��-� iC�.� �5�� � <�S'�
Address: City: State: Zip:
Col -11r Iter . .
L Phone: Fax: 9 2 0
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Address: city )/,, Q State: tip . Zip: 9 767/.
City Business Lie: Z.:, r., 6 2. ?) / f 0
License No: (OP/ 1 ,,v 6 0 3 t! /1-6
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Contact ' ,_ ;...
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Name: Phone
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DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
X
$12.00
=
2
FUEL BURNING APPLIANCE
More than 100,000
/
X
$15.D0
=
/s
3
UNLISTED APPLIANCE (Additional Fee)
Equal to or less 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
$50.00
=
6
USED APPLIANCE (WSEC min. AFUE rating)
More than 400,000
X
5100.00
=
7
BOILER/REFRIGERATION
1-100M BTU
X
512.00
=
8
BOILER/REFRIGERATION
101 - 500M BTU
X
520.00
=
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
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
$1.0D
=
/4 60
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
$12.00
=
21
AIR HANDLER (DOES NOT include ducting)
Greater than 10,000 CFM
X
515.00
=
22
EVAPORATIVE COOLERS
X
$10.00
=
23
TYPE I HOOD
X
550.00
=
24
TYPE II HOOD
X
510.00
=
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
X
$12.00
=
26
AIR CONDITIONER
3-15 TON
X
520.00
=
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
$10.00
=
31
WOOD OR PELLET STOVE/INSERT
X
510.00
=
32
WOOD STOVE - FREE STANDING
X
$25.00
=
33
REPAIR & ADDITIONS
X
515.00
=
34
VENTILATION SYSTEMS
X
$12.00
=
35
VENTILATION MECHANICAL EXHAUST
X
512.00
=
36
INCINERATOR - RESIDENCE
X
$19.00
=
37
INCINERATOR - COMMERCIAL
X
$22.00
=
METHOD OF PAYMENT:
['CASH 0 CHECK ❑ VISA 0 MC
CARD #:
SUBTOTAL
EXPIRES:
PROCESSING FEE
535.00
VIN:
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
REVISED 11/25/05