2010, 11-18 Permit App: 10003838 Boiler Refrig, Piping?LL4s& r -)C COPY Or-
Spoka e�
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Conmum icy Development
Mechanical Permit Application ri Commercial
Permit Center
11703 E Sprague Axe, Suite H-3
Spokane Valley, WA 99206
(509)688-0036 FAX (509)688-0037
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PERMIT NUMBER:-sg
PERMIT FEE:
S 1
Residential
SI'It ADDRESS: 4/7 // Z.,4 -,2.c /IL /20,
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Name: Phone01 emg- &4/2h, Fax,
Address: 4/7 z q fV, t 4-,tcb izn c "` SPo/ AIDE 'opiate. b 0,4 'Ip 992/(c,
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Name € 4-2��-j- zwt/ /d,� Phnne'5o42/—/S/7,//L/ lax 5act-732-OS-0C,
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Address pc)30-7C CaLC.. City Lig-tr Liz, State /..0T ZIP 91q07
License No City liusmess Lie zoo Osup
Contact(/Q n j)ee-rsao 9,S/-"° 2-AS—
Name Phone
DESCRIPTION OF WORK
# OF UNITS
COST
= TOTAL AMOUNT
FUEL BURNING APPLIANCE
Equal to or less than 100,000
X
$12.00
2
FUEL BURNING APPLIANCE
More than 100.000
x
515.00
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 sioo.00
5
USED APPLIANCE (WSEC min. AFUE rating)
Equal to or less than 400,000
X
550 00
6
USED APPLIANCE (WSEC min, AFUE rating)
More than 400,000
X $10000
7
BOILER/REFRIGERATION
1 - 100M BTU
X
$12.00
8
BOILER/REFRIGERATION
101 - 500M BTU
1
x
$20 00
zD
9
BOILER/REFRIGERATION
501 - 1,000M BTU
X
$25 00
10
BOILER/REFRIGERATION
1,001 - 1,750M BTU
X
535 00
11
BOILER/REFRIGERATION
More than 1,750M BTU
X
560.00
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
16
MISC FUEL BURNING APPLIANCE
X
$10 00
17
GAS PIPING (each outlet)
/
$1 00
18
DUCT SYSTEMS
X
$10.00
19
VENTILATING FANS
X
510 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
$10.00
23
TYPE IHOOD
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
535 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
S25 00
33
REPAIR & ADDITIONS
x
515.00
34
VENTILATION SYSTEMS
x
512.00
35
VENTILATION MECHANICAL EXHAUST
x
512.00
36
INCINERATOR — RESIDENCE
x
519.00
37
INCINERATOR — COMMERCIAL
x
$22.00
METHOD OF PAYMENT:
DCASH 0 CHECK 0 VISA 0 MC
CARD #
AUTHORIZED SIGNATURE:
REVISED 820,05
EXPIRES.
VIN
SUBTOTAL
2/5
PROCESSING FEE
535.00
TOTAL PERMIT FEE DUE: