2007, 11-09 Permit App: 07004512 Mechanical Fixtures a
Permit Center
Sokane 11703E Sprague Ave,Suite B-3
h Spokane Valley,WA 99206 PERMIT NUMBER: \
00 Valley (509)688-0036 FAX:(509)688-0037
Community Development
www.spokanevallev.ore PERMIT FEE: /711_,(_'' :,
Mechanical Permit Application n Commercial n Residential
SITE ADDRESS: IBJ I O ( L" 1-)r,)
Building Owner
Name: Phone: Fax:
Address: City: State: Zip:
Contractor
Name: 1 • //�� l
�le_csx,.tfl I� 11 Pho l' / 1_ 1 IL,t" Fax:
Address: j ' City: l State:Iii Zip: ?
License No: City Business Lic:
Contact
Name: Phone:
DESCRIPTION OF WORK #OF UNITS X COST = TOTAL AMOUNT
1 FUEL BURNING APPLIANCE Equal to or less than 100,000 # ' X $12.00 = �) 1 Q�O(\,
2 FUEL BURNING APPLIANCE More than 100,000 X $15.00 = v
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 X $10.00 =
13 RANGE X $10.00 =
14 DRYER X $10.00 =
15 FUEL BURNING WATER HEATER ' X $10.00 = IL
16 MISC.FUEL BURNING APPLIANCE X $10.00 =
17 GAS PIPING(each outlet) ) X $1.00 = ` .liu
18 DUCT SYSTEMS X $10.00 = 0
19 VENTILATING FANS X $10.00 = ,.3C
20 AIR HANDLER(DOES NOT include ducting) - Equal to or less than 10,000 CFM X $12.00 =
I
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 $10.00 =
25 HEAT PUMP/AIR CONDITIONER 0-3 TON X $12.00 =
26 AIR CONDITIONER 4-15 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 =
33 REPAIR&ADDITIONS X $15.00 =
34 VENTILATION SYSTEMS X $12.00 =
35 VENTILATION MECHANICAL EXHAUST X $12.00 =
36 INCINERATOR-RESIDENCE X $19.00 =
37 INCINERATOR-COMMERCIAL X $22.00 =
METHOD OF PAYMENT: SUBTOTAL
❑CASH 0 CHECK ❑VISA 0 MC EXPIRES. PROCESSING FEE $35.00
CARD#: VIN: TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
REVISED 8/26/05