2006, 07-28 Permit App: 06002916 AC.000 Malley
Permit Center
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036' FAX: (519)688-0037
Community Development www.spokanevalley.ora.com
Mechanical Permit Application
o Commercial Residential
SITE ADDRESS E • 72 Co a M ttA...
Building owner
Name: DAAA.,r • CLP 'r der- Phone: TAB - c7 / Ds"' Fax
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Address: (• 720 B len A.,.. City Sp ,a_ V. State (4 w - Zip 77 aj.4
Contractor
Name: %4/(JDV,S0A) ' S /le A -7-/A)6 S I%mthi)6Phone: 9. s- •' al & Fax: qaa - 3/19
Address: 5, /$ qp 3-rjt.e.4- City V, Q State wA - Zip 19 a./-4
License No: hAaffitSfyi /it 7 B 7 City Business License o:
Contact
Name: Phone:
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
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 Tess 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
3-15 TON
/
X
$20.00
=
;jp , Ira
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
=
METHOD OF PAYMENT:
❑CASH ;4 CHECK ❑ VISA ❑ MC
CARD #:
SUBTOTAL
DATE:
PROCESSING FEE
$35.00
EXPIRES:
TOTAL PERMIT FEE DUE:
# ,,c ; pe
AUTHORIZED SIGNATURE:
REVISED 8/26/05