2004, 09-24 Permit App: BLD-04-07757 Gas Piping••"\t,
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Project Address: / ��� GlCi- ;11 •
Owner. /'7,-k' 11" cher
Mailing Address: /„nMe.r'
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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
Contractor: i 1'zt.l h
Permit Use:
Phone (Daytime Contact):
Mai Ing Address:
License #:
City
State
Phone #:
. Zip Code
City
State
DESCRIPTION OF WORK
FUEL BURNING APPLIANCE
fUE -BURNINGAPPLIANCE
# OF
UNITS X COST
TOTAL
AMOUNT
Equal to or less than 100,000
More Bran 100,000
X 1 $15.00
Zip Code
X ( $19.00
UNLISTED APPLIANCE (Additional Fee)
UNLISTED APPLIANCE (Additional Fee)
Equal to or less than 400,000
More than 400,000
X 1 $50.00
$100.00
USED APPLIANCE (WSEC max AFUE
rating
USED APPLIANCE (WSEC min. AFUE
rating)
Equal to or fess than 400,000
$50.00
More than 400,000
X 1 $100.00
7 BOILER/REFRIGERATION
8 BOI€ER/REFRIGERAT1ON
9 BOILER/REFRIGERATION
1 -100M BTU
101 - 500M BTU
501 -1,000M BTU
X $15.00
X $28.00
X $39.00
10 BOILER/REFRIGERATION 1,001 -1,750M BTU
X 1 $57.00
11 j BOILER/REFRIGERATION 1 More than 1,750M BTU
X r $95.00
12 1 GAS LOG, GAS INSERT, GAS FIREPLACE
X I $40.00
13 1 RANGE
X 1 $10.00
14 I DRYER
15 FUEL BURNING WATER HEATER
X 4 $10.00
X }I $10.00
16 MISC. FUEL BURNING APPLIANCE
47 GAS PIPING (each outlet)
18 DUCT SYSTEMS
X $10.00
X $1.00
X $10.00
19 VENTILATING FANS
20 AIR HANDLER (DOES NOT include ducting) Equal to or less than 10,000 CFM
21 AIR HANDLER (DOES NOT include ducting) Greater than 10,000 CFM
X *10.00
X $12.00
X $19.00
22 1 EVAPORATIVE COOLERS
X 1 $10.00
23 TYPE 'HOOD
24 TYPE II HOOD
25 HEAT PUMP/AIR CONDITIONER 0.3 TON
X $50.00
X $10.00
X $12.00
26 f AIR CONDITIONER 3-15 TON
X 1 $20.00
27 AIR CONDITIONER
28 AIR CONDITIONER
29 AIR CONDITIONER
15-30 TON
30.50 TON
More than. 50 TON
X $25.00
X $35.00
X $60.00
30 1 LPG STORAGE TANK
31
32
WOOD OR PELLET STOVE/INSERT
WOOD STOVE - FREE STANDING
METHOD OF PAYMENT:
Q CASH Q CHECK Q VISA Q MC
CARD #:
AUTHORIZED SIGNATURE:
DATE:
EXPIRES:
X 1 $10.00
X $10.00
X $25.00
SUBTOTAL
PROCESSING FEE
( cc
$35.00
TOTAL PERMIT FEE DUE:
.36.c.10
36C.10
lJ j� S !
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