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2009, 03-05 Permit App: 09000530 Wood StovePermit Center Slane11703 E Sprague Ave, Suite B-3�C� pOSpokane Valley, WA 99206 PERMIT NUMBER: aosValley'` (509)688-0036 FAX (509)688-0037 1 Community Development pemnncenter@sookanevallev.or>; ,_,/ PERMIT FEE: �� Mechanical Permit Application ❑ Commercial I �� Residential srrE ADDRESS: Iph O9 1✓ YY\iSSio('1 A()E Building Owner _: - Name: -Too t r1Y ber �c ..)� a KS Phone: S)Ct�a'"I IO S Fax. Address: IGbOqt h\ISSI0 Y} ✓h1E City' UrcaAe JG(Iej State: (.A) Zip: q`1aDb Contractor - _- - - J - - --- - - -_- - Name: Name: Phone' Fax: Address City: State: Zip: License No: City Business Lie: Contact - - - - - Name- "—T.:0 \0 ) 5, -pct c r Phone: ' 362 .,-35o / — P "-3—Ctc�7. U¢ I &— DESCRIPTION OF WORK # OF UNITS X COST = TOTAL AMOUNT 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 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 METHOD OF PAYMENT: ❑CASH (KrIECK D VISA DMC CARD # AUTHORIZED SIGNATURE: REVISED t26/05 EXPIRES: VIN: SUBTOTAL 'd5-00 PROCESSING FEE $35.00 TOTAL PERMIT FEE DUE: GOD()