2009, 02-06 Permit App: 09000268 Mechanical FixturesPERMIT NUMBER:
PERMIT FEE:
(Staff Use Only)
C\1 (_57
CITY OF SPOKANE VALLEY
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
permitcenter@spokanevalley.org
MECHANICAL PERMIT APPLICATION
❑ COMMERCIAL ® RESIDENTIAL
SITE ADDRESS:1423 N. LILY
BUILDING OWNER NAME:MARTIN GISOLO
NAME:MARTIN GISOLO
ADDRESS:1423 N. LILY
CIrv:SPOKANE VALLEY STATE:WA Zip:99212
PHONE:509-991-7057 FAX: CELL:
CONTACT NAME:MARTIN GISOLO
PHONE:509-991-7057 FAX: CELL:
CONTRACTOR NAME:SMITH HEATING & COOLING, INC.
MAILING ADDRESS:102 E. NORA AVE.
CITY:SPOKANE
STATE:WA ZIP:99207
PHONE:509-328-4431 FAx:509-328-0749 CELL:
CONTRACTOR LICENSE NO.:SMITHHCOHORS
No.:L0915772
EXPIRES:1-8-11 CITY BUSINESS LICENSE
MANUFACTURER:
PREVIOUS ADDRESS:
PROPOSED USE:
Effective October 28, 2007 Page 1 of 2
http://www.spokanevalley.org/uploads/Community_Development/Documents/Forms/Building/Mechancial Permit App.1.doc
DISCLAIMER
The permitted verifies, acknowledges and agrees by their signature that: 1) if this permit is for construction or on a dwelling, the dwelling is/will
be served by potable water. 2) Ownership of this City of Spokane Valley permit inure to the property owner. 3) The signatory is the property
owner or has permission to represent the property owner in this transaction. 4) All construction is to be done in full compliance with the City of
Spokane Valley Development code. Referenced codes are available for review at the City of Spokane Valley Permit Center. 5) The City of
Spokane Valley permit is not a permit or approval for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional
Information may be required to be submitted and subsequently approved before this application can be processed.
Signature R9,6• -
Date:02-06-09
Method of payment: ❑ Cash ® Check
Bankcard #:
❑ Visa ❑ Mastercard
EXP: VIN#:
Authorized Signature:
Effective October 28, 2007 Page 2 of 2
http://www.spokanevalley.org/uploads/Community_Development/Documents/Forms/Building/Mechancial Permit App.1.doc
# OF UNITS
1
X
X
X
X
X
COST
$12.00
$15.00
$50.00
$100.00
=
=
TOTAL AMOUNT
12.00
DESCRIPTION OF WORK
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
- -
=
=
2
FUEL BURNING APPLIANCE
More than 100,000
3
UNLISTED APPLIANCE (Additional Fee)
Equal to or less than 400,000
Fee)
400,000
More thanX
4
UNLISTED APPLIANCE (Additional
AFUE rating)
Equal to or Tess than 400,000
$50.00
=
5
USED APPLIANCE (WSEC min.
min. AFUE rating)
More than 400,000
X
$100.00.
=
6
USED APPLIANCE (WSEC
1 - 100M BTU
X
$12.00
=
7
BOILER/REFRIGERATION
X
$20.00
=
101 - 500M BTU
8
BOILER/REFRIGERATION
501 - 1,000M BTU
X
$25.00
=
9
BOILER/REFRIGERATION
X
$35.00
=
1,001 - 1,750M BTU
10
BOILER/REFRIGERATION
X
$60.00
=
More than 1,750M BTU
_
11
BOILER/REFRIGERATION
X
$10.00
=
10.00
INSERT, GAS FIREPLACE
1
12
GAS LOG, GAS
X
$10.00
=
13
RANGE
X
$10.00
=
14
DRYER
WATER HEATER
X
$10.00
15
FUEL BURNING
BURNING APPLIANCE
X
$10.00
=
16
MISC. FUEL
outlet)
3
X
$1.00
=
3.00
17
GAS PIPING (each
SYSTEMS
X
$10.00
=
18
DUCT
FANS
X
$10.00
=
19
VENTILATING
NOT include ducting)
Equal to or less than 10,000 CFM
X
$12.00
=
20
AIR HANDLER (DOES
NOT include ducting)
Greater than 10,000 CFM
X
$15.00
=
21
AIR HANDLER (DOES
COOLERS
X
$10.00
=
22
EVAPORATIVE
I HOOD
X
$50.00
=
23
TYPE
II HOOD
X
$10.00
=
24
TYPE
PUMP/AIR CONDITIONER
0-3 TON
X
$12.00
=
25
HEAT
CONDITIONER
4-15 TON
X
$20.00
_
26
AIR
CONDITIONER
15-30 TON
X
$25.00
=
27
AIR
AIR CONDITIONER
30-50 TON
X
$35.00
=
28
AIR CONDITIONER
More than 50 TON
X
$60.00
=
29
LPG STORAGE TANK
X
$10.00
=
30
31
WOOD OR PELLET STOVE/INSERT
X
$10.00
=
WOOD STOVE - FREE STANDING
X
$25.00
=
32
33
REPAIR & ADDITIONS
X
$15.00
=
SYSTEMS
X
$12.00
=
34
35
VENTILATION
VENTILATION MECHANICAL EXHAUST
X
$12.00
=
36
INCINERATOR - RESIDENCE
X
$19.00
=
37
INCINERATOR - COMMERCIAL
X
$22.00
=
SUBTOTAL
35.00
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
70.00
DISCLAIMER
The permitted verifies, acknowledges and agrees by their signature that: 1) if this permit is for construction or on a dwelling, the dwelling is/will
be served by potable water. 2) Ownership of this City of Spokane Valley permit inure to the property owner. 3) The signatory is the property
owner or has permission to represent the property owner in this transaction. 4) All construction is to be done in full compliance with the City of
Spokane Valley Development code. Referenced codes are available for review at the City of Spokane Valley Permit Center. 5) The City of
Spokane Valley permit is not a permit or approval for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional
Information may be required to be submitted and subsequently approved before this application can be processed.
Signature R9,6• -
Date:02-06-09
Method of payment: ❑ Cash ® Check
Bankcard #:
❑ Visa ❑ Mastercard
EXP: VIN#:
Authorized Signature:
Effective October 28, 2007 Page 2 of 2
http://www.spokanevalley.org/uploads/Community_Development/Documents/Forms/Building/Mechancial Permit App.1.doc