2004, 10-22 Permit App: BLD-04-08007 WoodstoveSTiolane
40,0Valley
Project A4 dress: / C/ c MSS:OKI /4=
Owner:
Mailing Address: /
/1it/s Si ar
MECHANICAL PERMIT APPLICATION
City of Spokane Valley Community Development Department
BuildingDivision
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
FOR INSPECTIONS, CALL (509) 688-0054
Permit Use: : s t ( icloodS
Phone (Daytime Contact): %-2 'I -R'6 79
s9a 64,s„C
City 7 State Zip Code
Contractor: License #: Phone #:
Mailing Address:
c
State
AUTHORIZED SIGNATURE:
Zip Code
DESCRIPTION OF WORK
# OF
UNITS
X
COST
= ,
TOTAL
AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
X
$15.00
=
2
FUEL BURNING APPLIANCE
More than 100 000
X
$19.00
=
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
$15.00
=
8
BOILER/REFRIGERATION
101 - 500M BTU
X
$28.00
=
9
BOILER/REFRIGERATION
501 -1,000M BTU
X
$39.00
=
10
BOILER/REFRIGERATION
1,001 -1 750M BTU
X
$57.00
=
11
BOILER/REFRIGERATION
More than 1,750M BTU
X
$95.00
=
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
$10.06
=
. 17
GAS PIPING (each outlet)
X
$1.0Q
=
18
DUCT SYSTEMS
X
510.00
=
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
$19.00
=
22
EVAPORATIVE COOLERS
X
$10.00
=
23
TYPE t HOOD
X
$50.00
=
24
TYPE II HOOD
X
$10.00
=
25
HEAT PUMP/AIR CONDITIONER
iia 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
$60.00
=
30
LPG STORAGE TANK•
X
$10.00
=
" 31
WOOD OR PELLET STOVE/INSERT
/
X
$10.00
=
/ 0 4-'1)
32
• WOOD STOVE - FREE STANDING
X
825.00
=
METHOD OF PAYMENT:
LSYCASH 0 CHECK 0 VISA Q MC
CARD #:
% �/
DATE: / �/a 1 /
SUBTOTAL
PROCESSING FEE
$35.00
EXPIRES.
TOTAL PERMIT FEE DUE
1715- ua
AUTHORIZED SIGNATURE:
Zip Code