2005, 03-28 Permit App: 05000997 Mechanical FixturesMECHANICAL PERMR.APaLICATION
Phone: (509) 668-0036; FAX: (509) 688-0037
For Inspections, Call (509) 688-0054
Project Address: tp /7( % /SSS/rJ)-)
(Owner: �'-Tt� •s �iw K /✓ r /` 7774doX
Mailing Address: e G// — `E — 1—/,said—, 6Pair +ue
Contractor:-''t's 4 A,+2 .- dAG� l/C License#:
Mailing Address:
05-99?
Community Development Departmen
Building Divisior
11707 E. Sprague Avenue, Suite 10E
Spokane Valley, WA 9920E
Permit Use:
Phone (Daytime Confect):
Ctty State Zip Code
Phone #: 5D 5' -NS -5 - 9C
state
Zi P Code
AUTHORIZED SIGNATURE'
DESCRIPTION OF WORK
0 OF UNITS
X
COST
=
TOTAL AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
1
X
5t2.00
=
/a
2
FUEL BURNING APPLIANCE
More than 100,000
X
515 00
=
3
UNLISTED APPLIANCE (Additional Fee)
Equal to or less than 400,000
X
550.00
4
More than 400,000
X
5100.00
=
UNLISTED APPLIANCE (Additional Fee) -
5
USED APPLIANCE (WSEC min AFUE rating)
Equal to or less than 400,000
X
550.00
=
6
USED APPLIANCE (WSEC min. AFUE rating)
More than 400,000
X
5100 00
=
7
' BOILER/REFRIGERATION
1 - 100M BTU
X
512.00
=
8
BOILER/REFRIGERATION
101 - 500M BTU
X
520.00
=
9
BOILER/REFRIGERATION
501 - 1,000M BTU
X
525 00
=
10
BOILER/REFRIGERATION
1001-1,750M BTU
X
53500
=
11
BOILER/REFRIGERATION
More than 1,750M BTU
X
560 00
=
12
GAS LOG, GAS INSERT. GAS FIREPLACE •
X
• 510 00
=
13
RANGE
-
-X
510.00
=
14
DRYER
X
510.00
=
'
15
FUEL BURNING WATER HEATER
-
/
X
51000
=
IC)
16
MISC FUEL BURNING APPLIANCE "
X
510.00
17
GAS PIPING (each outlet)
04.
X
51.00
=
a
18
DUCT SYSTEMS
,Q,XI 54'/^S
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
512.00
=
,
21
AIR HANDLER (DOES NOT include ducting)
Greater than 10,000 CFM
• X
515 00
=
22
EVAPORATIVE COOLERS
X
510.00 '
=
23
TYPE I HOOD
X
550.00
=
24
TYPE II HOOD
X -
510.00
=
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
X
512.00
=
26
AIR CONDITIONER
3-15 TON
X
520.00 •
._
27
AIR CONDITIONER
15-30 TON
X
525.00
=
26
AIR CONDITIONER
30-50 TON
X
535.00
=
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
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
519.00
=
37
INCINERATOR — COMMERCIAL
X
522.00
METHOD OF PAYMENT:
❑ CASH %CHECK ❑ VISA 0 MC
CARD 5
�1 (�
DATE: si —a 1 -OS
SUBTOTAL
n �
/
9 "/ —
PROCESSING FEE(�fy�
EXPIRES.
TOTAL
PERMIT FEE DUE:
r535�..00
'bj— ,6- -/ (1 /)
AUTHORIZED SIGNATURE'