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2007, 11-26 Permit App: 07004649 PipingSpokane 4.000Ie. Community Development Mechanical Permit Application Permit Center 11703 E Sprague Ave, Suite B-3 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 www.spokan oval Iev.ore PERMIT NUMBER: CAA/ PERMIT FEE: / _ ❑ Commercial E Residential SITE ADDRESS: 100 N. /1 a PPi 7t «r4 Building Owner - Name: c R Y v / p V I (/ i•-)/}7 Q, y Phone' c3 `j ,c14 S Fax Address: $j iv /1toFF'yr' /ed. City Sia k- re l/41).,- State' A.'M Zip'g9a06 Contractor Name. Phone' Fax: Address: City: State Zip: License No: City Business Lie: Contact Name: ('hone: DESCRIPTION OF WORK a 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 $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 14 RANGE DRYER - X X $10 00 $10.00 15 FUEL BURNING WATER HEATER . X $10 00 16 MISC FUEL BURNING APPLIANCE X $10 00 17 GAS PIPING (each outlet) 1 X $1 00 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 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 1 HOOD X 550 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 525 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 522.00 METHOD OF PAYMENT: ❑CASH CARD # AUTHORIZED SIGNATURE: REVISED 8/26/05 0 CHECK 0 VISA 0 MC EXPIRES' VIN SUBTOTAL PROCESSING FEE - 535.00 TOTAL PERMIT FEE DUE: