2005, 04-27 Permit App: 05001350 Gas PipingMECHANICAL PERMIT APPLICATION
Lei Ni0kane 9
Phone: (509) 688-0036; FAX: (509) 688-0037
For Inspections, Call (509) 688-0054 '
alley
Project Address: 4404 J a 147u.)
Owner: Talc^ CV\c
Mailing Address: 4--20 4- S (-k, t lot -0
Contractor: c7,Q cc -
Mailing Address:
05 C-ornintitgelopment Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Permit Use:
Phone (Daytime Contact): -.38i
SPPk $ c L..)41tcci Ca), 9 20X -
City State Zip Code
Phone #:
License #:
0
State
Zip Code
AUTHORIZED SIGNATURE:
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
$15.00
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 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
11000
=
13
RANGE
X
$10.00
=
14
DRYER
X
$10 00
=
15
FUEL BURNING WATER HEATER
X
$10.00
=
16
MISC FUEL BURNING APPLIANCE
X
$10.00
=
17
GAS PIPING (each outlet)
-
I
X
$1.00
=
(�.
'S / JV
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
$15.00
=
22
EVAPORATIVE COOLERS
X
110 00
=
23
TYPE HOOD
X
$5000
=
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
$1000 '
_
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
119.00
=
37
INCINERATOR - COMMERCIAL
X
122.00
=
METHOD OF PAYMENT:
❑ CASH 0 CHECK 0 VISA 0 MC
CARD it
DATE'
SUBTOTAL
, UC/
PROCESSING FEE
135.00
EXPIRES: --
TOTAL PERMIT FEE DUE:
�!s
�3�UO
AUTHORIZED SIGNATURE: