2004, 05-07 Permit App: BLD-04-04290 Piping^a.
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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
4/ 7 Ce Permit Use:
Phone (Daytime Contact): =,- Y - 077 7
Project Address: i /0.4 / , 'r 0'
Owner: Da. "e L'; e- /
Mailing Address:
Contractor:
Sc, i'1 e
I
r yy am% Nu mb,”
Mai ing Address: N 3 4-7-1 �` S e
City State
License #: -77 ft(i A 07-7, Phone #:
State
S�/v/the
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Zip Code
gq-6s57
z/6
Zip Code
AUTHORIZED SIGNATURE:
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
$10.00
=
17
GAS PIPING (each outlet)
X
$1.00
=
1 v a
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
$19.00
=
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
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
=
32
WOOD STOVE - FREE STANDING
X
$25.00
=
METHOD OF PAYMENT:
0 CASH "CHECK 0 VISA 0 MC
CARD #:
DATE:
SUBTOTAL
.a , 0 0
PROCESSING FEE
$35.00
EXPIRES:
TOTAL PERMIT FEE DUE:
3 /, (7 0
AUTHORIZED SIGNATURE: