2004, 03-04 Permit App: BLD-04-03684 Range, Pipingp
Sar,okane `�\kn
#Valley gii5/
1� ova oehis 7 -
Project Address:
Owner:
Mailing Address
Contractor:
ZIAV / Wh.E.2./4-rG15
U, S
MECHANICAL PERMIT APPLICATION
City of Spokane Valley Community Development Department
BuildingDivision
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
FOR INSPECTIONS, CALL (509) 688-0054
Permit Use: & f-5- .P/AJ
Phone (Daytime Contact): �7 (o 7/3-
.L /1J( License
ty . State
u J Phone #:
Zip Code 7aod
Mailing Address:
State
City 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
$15.00
=
2
FUEL BURNING APPLIANCE
More than 100,000
X
$19_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
5100.00
7
BOILER/REFRIGERATION
1 - 100M BTU
X
515.00
=
8
BOILER/REFRIGERATION
101 - 500M BTU
X
$28.00•
=
9
BOILER/REFRIGERATION
501 - 1,000M BTU
X
$39.00
10
BOILER/REFRIGERATION
1,001 - 1,750M BTU
X
$57.00
=
11
BOILER/REFRIGERATION
More than 1,750M BTU
X
$95.00
12
GAS LOG, GAS INSERT, GAS FIREPLACE
X
$10.00
13
RANGE
/
X
$10.00
=
/000
14
DRYER
X
510.00
=
15
FUEL BURNING WATER HEATER
X
$10.00
=
16
MISC FUEL BURNING APPLIANCE
X
510 00
=
17
GAS PIPING (each outlet)
-
X
$1.00
=
/t 0 0
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
519.00
=
22
EVAPORATIVE COOLERS
X
510.00
=
23
TYPE 1 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
$25.00
=
28
AIR CONDITIONER
30-50 TON
X
$35.00
=
29
AIR CONDITIONER
More than 50 TON
X
560.00
=
30
LPG STORAGE TANK
X
510.00
=
31
WOOD OR PELLET STOVE/INSERT
X
510.00
32
WOOD STOVE - FREE STANDING
X
$25.00
=
METHOD OF PAYMENT:
0 CASH ❑ CHECK 0 VISA ❑ MC
CARD #:
DATE:
SUBTOTAL
PROCESSING FEE
$35.00
EXPIRES:
TOTAL PERMIT FEE DUE:
Z7/4 O V
AUTHORIZED SIGNATURE: