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2005, 03-02 Permit App: 05000605 Mechanical Fixtures
diValklY Project Add4ess: blitA 4,4 - Owner: MECHANICAL PERMIT APPLICATION Phone: (509) 688-0036; FAX: (509) 688-0037 For Inspections, Call (509) 688-0054 Mailing Address: SP CUM if: - 57% Mailing Add Contractor: Address: 2.07 -S. 1 Community Development Department Building Division 11707 E. Sprague Avenue, Suite 106 Spokane Valley, WA 99206 Permit Use: Phone (Daytime Contact): City State License #: -SPOJ, 5 9//..4 Phone #: 6,1' it) 4-(4163 ra State Zip Code di- Zip ;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 $1'2.00 = / L -60 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/REFRIGERAT1ON 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 = /0 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 = / - ©U 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 . 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 = 33 REPAIR & ADDITIONS X $15.00 = 34 VENTILATION SYSTEMS X $12.00 = 35 VENTILATION MECHANICAL EXHAUST X $12.00 = 36 INCINERATOR - RESIDENCE f' X $19.00 = 37 INCINERATOR - COMMERCIAL X $22.00 = .. METHOD OF PAYMENT: 0 CASH CHECK 0 VISA 0 MC rartn x r-� _ q _ 4.,- DATE: C• SUBTOTAL 7 ? 2- 00 PROCESSING FEE $35.00 EXPIRES: TOTAL PERMIT FEE DUE: d U AUTHORIZED SIGNATURE: