2005, 01-12 Permit App: 05000119 Mechanical Fixtuers e ii-- 0 I. t 9
/'� MECHANICAL PERMIT APPLICATION Community Development Department
\ Building Division
1llq Phone: (509) 688-0036; FAX: (569) 688-0037 11707 E. Sprague Avenue, Suite 106
Ydl For Inspections, Call(509) 688-0054 Spokane Valley, WA 99206
Project Address: /2-7 / ,0,4„...,., ' / Permit Use:
Owner ,j-r.Q,Je ,A i)$ Phone (Daytime Contact): 91-1 "7 9.y.
Mailing Address: /-2 1 1 QJ 2 ,.s - .4A-et-if l�Q 7?2•/2
�do ty State Zip Code
Contractor: License#: Phone#:
Mailing Address:
City State Zip Code
DESCRIPTION OF WORK #OF UNITS X COST = TOTAL AMOUNT
1 FUEL BURNING APPLIANCE Equal to or less than 100,000 I. 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 $10 00 =
13 RANGE _ ,r X $10 00 =
14 DRYER - X $10 00 =
15 FUEL BURNING WATER HEATER i ` X $10 00 =
16 MISC FUEL BURNING APPLIANCEX $10.00 =
17 GAS PIPING(each outlet) / X $1.00 =
18 DUCT SYSTEMSX _ $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 COOLERSX $10 00 =
23 TYPE I HOOD - X $50 00 _
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 560.00 =
30 LPG STORAGE TANK X $10.00 t =
31 WOOD OR PELLET STOVEIINSERT X 1 $10 00 =
32 WOOD STOVE-FREE STANDING X $25.00 =
33 REPAIR&ADDITIONSX , 515.00 =
34 VENTILATION SYSTEMS X $12.00 =
35 VENTILATION MECHANICAL EXHAUST - X $12.00 =
36 INCINERATOR—RESIDENCEX $19.00 =
37 INCINERATOR—COMMERCIAL X $22.00 =
METHOD OF PAYMENT: SUBTOTAL
0 CASH 0 CHECK 0 VISA 0 MC DATE PROCESSING FEE $35.00
CARD 8 EXPIRES TOTAL PERMIT FEE DUE: 17 I.C0-
AUTHORIZED SIGNATURE