2006, 04-04 Permit App: 06001164 Mechanical FixtureMECHANICAL PERMIT APPLICATION
Phone: (509) 688-0036; FAX: (509) 688-0037
For Inspections, Call (509) 688-0054
Project Address: Permit Use:
Owner.
Mailing Address:
Contractor: ,
Mailing Address:
Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
-iZ44r(L. 17tC6As4rc2S. Phone (Daytime Contact):
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City State Zip Code
License#: Phone#: 51)9-3a5--QC3 (
79202 --
State Zip Code
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City
AUTHORIZED SIGNATURE-
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
X
512.00
=
/ Z '
2
FUEL BURNING APPLIANCE
More than 100,000
X
515.00
=
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
5100.00
=
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
$12 OD
=
8
BOILER/REFRIGERATION
101 - SOOM BTU
X
$20 00
9
BOILER/REFRIGERATION
501 - 1,000M BTU
X
$25.00
=
10
BOILER/REFRIGERATION
1.001 - 1,750M BTU
X
$35 D0
=
11
BOILER/REFRIGERATION
More than 1,750M BTU
X
560.00
=
12
GAS LOG, GAS INSERT, GAS FIREPLACE
X
$10 OD
13
RANGE -
X
$10.00
=
14
DRYER
X
510.00
15
FUEL BURNING WATER HEATER
X
510.00
=
16
MISC. FUEL BURNING APPLIANCE
X
510.00
=
17
GAS PIPING (each outlet)
X
$1 00
=
/
18
DUCT SYSTEMS
X
510 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
515.00
=
22
EVAPORATIVE COOLERS
X
510 DO
=
23
TYPE I 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 DO
27
AIR CONDITIONER
15-30 TON
X
525.00
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
510.00
32
WOOD STOVE - FREE STANDING
X
525.00
33
REPAIR & ADDITIONS
-
X
515.00
=
34
VENTILATION SYSTEMS -
X
512.00
=
35
VENTILATION MECHANICAL EXHAUST
X
512.00
=
36
INCINERATOR - RESIDENCE
X
$19.00
=
37
INCINERATOR - COMMERCIAL
X
$22.00
=
METHOD OF PAYMENT:
❑ CASH 0 CHECK 0 VISA 0 MC
CARD #:
DATES
SUBTOTAL
O0
/ 3 -
PROCESSING FEE
$35.00
EXPIRES: -
TOTAL PERMIT FEE DUE:
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AUTHORIZED SIGNATURE-