2008, 10-28 Permit App: 08004259 Mechanical FixturesSj�1'
llTT
PERMIT NUMBER:
(Staff Use Only)
PERMIT FEE: �'✓ r
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
permitcenterftspokaneval ley.orq
MECHANICAL PERMIT APPLICATION
COMMERCIAL El RESIDENTIAL
SITE ADDRESS:11204 E MALLON AVE, SPOKANE VALLEY, WA 99206
BUILDING OWNER NAME:CAROL KOONTZ
NAME:CAROL KOONTZ
ADDRESS:11204 E MALLON AVE
CITT:SPOKANE
STATE:WA ZIp:99206
PHONE:509-928-6666
FAX: CELL:
CONTACT NAME:CAROL KOONTZ
PHONE:509-928-6666
FAX: CELL:
CONTRACTOR NAME:NORCO HEATING AND AIR CONDITIONING CO
MAILING ADDRESS:5103 E TRENT
CITT:SPOKANE
STATE:WA ZIP:99212
PHONE:509-534-4975 FAx:509-534-1572
CELL:
CONTRACTOR LICENSE No.:NORCOHA17ORZ
LICENSE NO.:600-506-799
EXPIRES:10/09/2009 CITY BUSINESS
MANUFACTURER:LENNOX
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
Date:
Method of payment: 0 Cash 0 Check
Bankcard #:
0 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
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
1
X
$12.00
=
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
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)
X
$1.00
=
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
$15.00
=
22
EVAPORATIVE COOLERS
X
$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
4-15 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
$60.00
=
30
LPG STORAGE TANK
X
$10.00
=
31
WOOD OR PELLET STOVE/INSERT
X
$10.00
=
32
WOOD STOVE - FREE STANDING
X
$25.00
=
33
REPAIR & ADDITIONS
X
$15.00
=
34
VENTILATION SYSTEMS
X
$12.00
=
35
VENTILATION MECHANICAL EXHAUST
X
$12.00
=
36
INCINERATOR - RESIDENCE
X
$19.00
=
37
INCINERATOR - COMMERCIAL
X
$22.00
=
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
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
Date:
Method of payment: 0 Cash 0 Check
Bankcard #:
0 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