2006, 05-10 Permit App: 06001731 ResidenceProject Number: 06001731 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 5/10/2006 Page 1 of 3
Project Information:
Permit Use: NEW RESIDENCE W/ATTACHED GARAGE -GAS
Setbacks: Front
Site Information:
Plat Key:
Left: Right: Rear:
Name: Range
Contact: SULLIVAN HOMES
Address: 16114 E INDIANA AVE SUITE 200
C - S - Z: SPOKANE VALLEY, WA 99216
Phone: (509) 624-4598
Group Name:
Project Name:
District:
Parcel Number: 55073.2613 Block:
SiteAddress: 17221 E NORA AVE
Location:: CSV
Lot:
Owner: Name: SULLIVAN HOMES
Address: 16114 E INDIANA AVE
SPOKANE VALLEY, WA 99216
Zoning: UR -3.5 Urban Residential 3.5
Water District: Hold: ❑
Width: 0 Depth: 0 Right Of Way (ft): 0
Area: .00 Acres
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Information:
Review
Building Plan Review
Released:B
Driveway/Approach
Originally Released: 5/10/2006 By: TMELBOU
Rele
ed
Originally Released: 5/10/2006 By: amblake
Landuse/Zoning/HE Conditions
Released By:
Sewer Review
Permits:
Originally Released:
5/9/2006 By: HMStinson
Released By:
Operator: CJJ
Printed By: AMB
Print Date:
5/10/2006
Project Number: 06001731 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 5/10/2006 Page 2 of 3
Contractor: SULLIVAN HOMES LLC
Address: 16114 E INDIANA AVE STE 200 Phone: (509) 624-4598
SPOKANE VALLEY, WA 99216
Approach
Firm: SULLIVAN HOMES INC
Item Description Units Unit Desc Fee Amount
APPROACH -CONST IN ROW 1 NUMBER OF $50.00
Contractor: SULLIVAN HOMES LLC
Address: 16114 E INDIANA AVE STE 200 Phone: (509) 624-4598
SPOKANE VALLEY, WA 99216
Permit Total Fees:
Building Permit
$50.00
Firm: SULLIVAN HOMES INC
This Application: Total Project:
Description Grp "'mg Notes SQ Ft Valuation Su Ft Valuation
1&2 FAMILY R-3 VB 1,349 $116,513.13 1,349 $116,513.13
DECK OPEN R-3 VB 60 $900.00 60 $900.00
GAR WOOD U-1 VB 672 $12,768.00 672 $12,768.00
Item Description
RESIDENTIAL PERMIT FEE
WSBC SURCHARGE
SF PLNS RVW < 7999 SQ FT
Contractor: STURM HEATING
Address: 1112 N NELSON
SPOKANE, WA 99202
Item Description
DUCT SYSTEMS
GAS WATER HEATER
GAS APPLIANCE<=100,000BTU
GAS PIPING
VENTILATING FANS
GAS LOG OR GAS INSERT
HOOD -TYPE II
Totals: 2,081 $130,181.13 2,081 $130,181.13
Units
1
1
1
Unit Desc
SELECT
SELECT
SELECT
Permit Total Fees:
Mechanical Permit
Fee Amount
$1,167.35
$4.50
$466.94
$1,638.79
Firm: STURM HEATING
Phone: (509) 325-4505
Units Unit Desc
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
3 # OF UNITS
4 NUMBER OF
1 NUMBER OF
I NUMBER OF
Operator: CJJ Printed By: AMB
Permit Total Fees:
Print Date:
Fee Amount
$10.00
$10.00
$12.00
$3.00
$40.00
$10.00
$10.00
$95.00
5/10/2006
Project Number: 06001731 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 5/10/2006 Page 3 of 3
Plumbing Permit
Contractor: STURM HEATING Firm: STURM HEATING
Address: 1112 N NELSON Phone: (509) 325-4505
SPOKANE, WA 99202
Item Description
TOILETS/BIDETS
SINKS
SHOWERS
TUBS
DISH WASHERS
GARBAGE DISPOSAL
CLOTHES WASHER
WATER PIPING - DWV
Notes:
Payment Summary:
Permit Type
Approach
Building Permit
Mechanical Permit
Plumbing Permit
Units Unit Desc
3 NUMBER OF
6 NUMBER OF
3 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
3 NUMBER OF
Permit Total Fees:
Fee Amount
$50.00
$1,638.79
$95.00
$114.00
Invoice Amount
$50.00
$1,638.79
$95.00
$114.00
Fee Amount
$18.00
$36.00
$18.00
$6.00
$6.00
$6.00
$6.00
$18.00
Amount Paid
$0.00
$0.00
$0.00
$0.00
$114.00
Amount Owing
$50.00
$1,638.79
$95.00
$114.00
$1,897.79 $1,897.79 $0.00 $1,897.79
Disclaimer:
Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and finds the information
contained within to be true and correct, and agrees that all provisions of laws and/or regulations governing this type of work will be
complied with. Subsequent issuance of a permit shall not be construed to be a permit for, or an approval of, any violation of any of
the provisions of the code or of any other state or local laws or ordinances.
Signature:
Operator: CJJ Printed By: AMB Print Date: 5/10/2006
0004\46..,
.001/alley
BUILDING PERMIT APPLICATION WORKSHEET
City of Spokane Valley Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
Street Address: 17221 E Nora Ave Spokane Valley 99216
Assessor's Tax Parcel Number(s):
Legal Description: Lot 4 Block 2 Inverness P.U.D.
PERMIT DESCRIPTION: New Residential Construction
® Building Permit
❑ Relocation
❑ Change in Use ❑ Grading ❑ Manufactured Home
❑ Tenant Improvement ❑ Fire Safety ❑ Other
Owner: Sullivan Homes
Phone: 509-624-4598 Fax:
Address: 16114 E. Indiana Ave
City: Spokane Valley State: WA Zip: 99216
❑ Contractor: Same
Phone: Fax:
Address:
City: State: Zip:
WA State Contractor License #: Sullihi042JT
❑ Applicant: Same
Phone: Fax:
Address:
City: State: Zip:
❑ Architect:
Phone: Fax:
Address:
City: State: Zip:
Contact: Evan Hughes
HEIGHT TO PEAK: 19'-0"
DIMENSIONS: 50'-0" x 55'-0"
# OF STORIES: 1
MAIN FLOOR TO SQ. FTG: 1349 sf
are—
2ND FLOOR SQ. FTG: N/A
UNFIN BASEMENT SQ. FTG: N/A
FINISHED BASEMENT SQ. FTG: N/A
GARAGE SQ. FTG: 672 SF K—
DECK/COV. PATIO SQ. FTG: bio
OCCUPANCY GROUP: Single Family
CONSTRUCTION TYPE: Residential
HEAT SOURCE: GAS
# OF BEDROOMS: 2
TOTAL HABITABLE SPACE: 1349 sf
.1) Ii ---
IMPERVIOUS SURFACE AREA:
COST OF PROJECT: $195,000
30% SLOPES ON PROPERTY: NO
SEWER OR ON-SITE SEPTIC
SYSTEM? Sewer
MANUFACTURED HOME
Width:
Manufacturer:
Length:
Year:
Pit Set:
Previous Address:
Proposed Use:
Fire Sprinkler:
Tent:
Valuation:
Plans Examiner:
Address:
Inspector:
Address:
# of Heads Fire Alarm:
Fireworks Display: Blasting:
Above/Underground Storage Tank Size:
Paint Booth:
Date/Time:
WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE
Phone:
City, State, Zip:
Phone:
City, State, Zip:
Fax:
Fax:
❑ BOLTING ❑ CONCRETE
Firm Name:
Inspector(s):
❑ REINFORCEMENT
Phone:
Fax:
❑ WELDING
DISCLAIMER
The permitee verifies, acknowledges and agrees by their signature that: 1) If this permit is for construction of or on a
dwelling, the dwelling is/will be served by potable water. 2) Ownership of this City of Spokane Valley Permit inure to the
property owner. 3) The signatory is the property owner or has permission to represent the property owner in this
transaction. 4) All construction is to be done in full compliance with the City of Spokane Valley Development Code.
Referenced codes are available for review at the City of Spokane Valley Permit Center. 5) This City of Spokane Valley
Permit is not a permit or approval for any violation of federal, state or local laws, codes or ordinances.
Ownership of resulting development rights granted by any issued permit inure to the property owner.
Print Name Signature
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
❑ Cash ❑ Check ❑ Mastercard ❑ VISA ❑ Other
Bankcard #: Expires: VIN#:
Authorized Signature:
,;1;1g R9 02 08:49a Dan Cenis
509-755-2713
2001•WSBC Residential Compliance Farre
Prescriptive (Chapter 6) Options for an R Occupancies, Climate Zone 2 O, 1.
Heat source• A T.T
-- .•,---n,.�ra�s�co-.,zreta: - - -""'='1} ::�, titer. --s-'• -...SnCoBb+
11\ISTRIIt_11ONS .
Z) You=w171 be processed more efficiently if you provide all of the requested infvm�atiolti Departni tt staff ran
help you with general gustiorzs about this fora_ Your building must notch the selected oplion iecl¢aemeals wifhaut
err elrtions or substitutions.
2) Glazing percentage determines which option to choose Complete the folio. wing glazing area calculation before
proceeding to the option table below_
p- 1
GLAZNG AREA CALCULATION_
INS sF.. (cf 5F = 1I
TOTAL WINDOW AREA_.. . ._..-T_E, A:I1ED FLOORARE4 TALL FLOORS.) 7 % OF GLAZING
NOTE Use laugh opening (R/O) for window area_ Itldade allhalf-liteand :fall -lite door oleaigin this
calculation:
CAN'T -COMPLY? If none of the Prescciptive (Chapter ) Options below are acxrpLable_ consider systems analysis
(Chapter 4) or, Coinpon.ent Perform;once (Chapter 5) Approach_ The maul ad.varttage is fleaobility to juggle individual U-
factors (R -values) as long as'an overall rna>drnum value isn't exuded_ Note that the overall percoralnance requirements
are i10 less stringent than the Presuiptive requirement Calculations map be performed by hand o using an acceptable
mulputer software program Helpful fou a and other resovims can be downloaded at http:// wwvv.6iergy.xstn.edn/
buildings
p' t
.QIRCLE
OPTION
• TABLE 6-2 .
• PRES CFLIFTIVE7,EQUIftEMENf"S4-.EdRGROUP R.;OCGUPAt CY
CLIMATE ZrDh1E 2
. •
�plion
Clan."'
% of Floor
GI aunt U-Fa�r Door 0
'rcrTin
Vaulted
Ce�Trg
-
Wall
Abova •_let`
. Grade
Well-
.
Eel -ow
Grade
Well.
.e#
I
Agars
i
Slab'
tut -
'Grde '
-Vertical'
Overhead" U -Factor
87eow
Grade
L 10°%
" a40
1158
120
R-39
R30 R21
R-21
. R-12
1130
' R-]0
1L.` 159:
0.40
• 031
.0,n
R-30.
-' 2-30 .
R-19+
11-5•
R-21
-R-R
11.-30i
5-10
MIL
t 7%
' 037
- OSB
0_20
11-39
R30
11-19 --'r
R -5t
R-21
.R-12
R-301
t
R -]O
LlnLm.n
Camay R-3
.Occupancy
035
OSB ,
0
1120,'
R-39 .-
R30
R-23
log
1-21
R-12
R-301 -
i
.
IOnly
R-10
• 0. 6lomuaa 1C -valves atm for wood hmne asscrnblies.onty or assemblies builr in accordance with Section 601.1_
1. Minim= require entsforoocboptioalisled_ For example, ifapropor r1 deoign]vasagir ingratiototheconditionedfloor
arca of 13%4 it chv11 comply with ail of cite icquirvae ofthe.15%.glamg option (or bigbis). Proposed•designs whicb cannot
meet the specific rcgaaircments of listml option above may calculate. compliance by 13aptas 4 or 5 of this Code.
•
. 2. Rcquirmacni uppli-0 to all ceSan ' exrspt sinslc rafter orjoistvaul>rd ceilings_ !Adv. -denotes Advanee5Franned C2tlmg
3,
RegnirmorentappLrable only to single rafter orjoutvanited cczlioFs:•
' 4.. Belowgade walls -stern be insulated either on me oRcoor to a 'minim -I'm level ofR-10, or on -b= 1, for to the sem'. level as
wallsabove grade. k exterior insulati ainstalled on below grade walls sba11be a want resisnnt material, manufactured for its
intended use, and iisslalied accordin6 to the manvfacturces specific zone. See Section 6OEL2 •
•
5. Floats over -crawl spaces or r3ptacd lo ambient air conditions.
• 6. Required slab pa-isnoter insulation shall be a uater rrticrvrtt material, mannf arsrad for its intended -um and Er, :114d
according to m=^ufucnrices'spccincitions_' Sce Sccrioa 6024: .• . ... .
7. Int, denotes staudisdfntnmg 16 incbrs on center with hendes insulated with a nrinunum ofR 5 insulation_
S_ This wailinsulanOn. requirement denotes IS --19 wall cavity insulaidonplus R--= foam.sheathing.
9. Doors, including all fire doors, Man be assigned defaok1T-factors from Table 10 -SC_
10. 'nett a ntaznaum glaang arca 'is Listed, The totalglaing arra (rximbin d ertiralplus ovcrbwdl as a percent of gross
raoditioncr£fioor orcar{:-.El be less than or egoalta that value. Overhead gL nrwith1TfactOr 0fU 0-40 or less is not ir cludcd
in glauug area Iimitations _ -
.IL. Ovcrhead glaringshall haveU-fa-rurs determined ioaccordancewithNP'RC]00orassneei5Sceiten50?1S-
12. Log and solid -Ember walls with a minimum avcraee tbiakaess of3 5 arc cmopt from this bamdation iegniremrart
ATTC,—c)0elle) ,ATT 11`7. / /1 All Erin !GC C 71 o T/l. nr nr`
SULLIVAN HOMES
INCORPORATED
TRANSMITTAL SHEET
TO: CITY OF SPOKANE VALLEY FROM:
Sullivan Homes
CONTACT: EVAN HUGHES DATE:
5/18/06
PHONE NUMBER: 509-624-4598
RE: 17221 E Nora. Ave Building Permit
0 URGENT X FOR REVIEW 0 PLEASE COMMENT 0 PLEASE REPLY 0 PLEASE RECYCLE
CONTENTS:
(2) FULL PLAN SETS 24" X 36"
(2) PLOT PLANS
(1) BUILDING PERMIT APPLICATION
(1) MECHANICAL PERMIT APPLICATION
(1) PLUMBING PERMIT APPLICATION
(1) RESIDENTIAL COMPLIANCE FORM
(1) GENERAL FACILITIES CHARGE
***PLEASE CONTACT US IF ALL OF LISTED ITEMS ARE NOT INCLUDED***
16114 E. INDIANA AVE, SUITE 200 • SPOKANE VALLEY, WASHINGTON • 99216
PHONE: 509.624.4598 • FAX: 509.624.4630
Proj ect•Number: 06001731 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
x...3t..W .a`fg,y .,w... +^ ...:-.•tas»;:-;,�:. as :awwwwwigwyo
Permit Use: NEW RESIDENCE W/ATTACHED GARAGE -GAS Contact: SULLIVAN HOMES
Address: 16114 E INDIANA AVE SUITE 200
C - S - Z: SPOKANE VALLEY, WA 99216
Setbacks: Front Phone: (509) 624-4598
Group Name:
Project Name:
Date: 05/08/2006 Page 1 of 2
Site Information:
Plat Key:
Left: Right: Rear:
Name: Range
District:
Parcel Number: 55073.2613
SiteAddress: 17221 E NORA AVE
Location:: CSV
Block:
Lot:
Owner: Name: SULLIVAN HOMES
Address: 16114 E INDIANA AVE
SPOKANE VALLEY, WA 99216
Zoning: UR -3.5 Urban Residential 3.5
Water District: Hold: ❑
Width: 0 Depth: 0 Right Of Way (ft): 0
Area: .00 Acres
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Information:
Review
Building Plan Review
Driveway/Approach
Released By
Landuse/Zoning/HE Conditions
Sewer Review
Permits:
ed By:
Released By:
Operator: CJJ Printed By: CJJ Print Date: 05/08/2006
Project -Number: 06001731 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 05/08/2006 Page 2 of 2
Approach
Contractor: SULLIVAN HOMES LLC Firm: SULLIVAN HOMES INC
Address: 16114 E INDIANA AVE STE 200 Phone: (509) 624-4598
SPOKANE VALLEY, WA 99216
Building Permit
Contractor: SULLIVAN HOMES LLC Firm: SULLIVAN HOMES INC
Address: 16114 E INDIANA AVE STE 200 Phone: (509) 624-4598
SPOKANE VALLEY, WA 99216
Mechanical Permit
Contractor: STURM HEATING Firm: STURM HEATING
Address: 1112 N NELSON Phone: (509) 325-4505
SPOKANE, WA 99202
Contractor: STURM HEATING
Address: 1112 N NELSON
SPOKANE, WA 99202
Notes:
Plumbing Permit
Firm: STURM HEATING
Phone: (509) 325-4505
Payment Summary:
ry
Disclaimer:
Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and finds the information
contained within to be true and correct, and agrees that all provisions of laws and/or regulations governing this type of work will be
complied with. Subsequent issuance of a permit shall not be construed to be a permit for, or an approval of, any violation of any of
the provisions of the code or of any other state or local laws or ordinances.
Signature:
Operator: CJJ Printed By: CJJ Print Date: 05/08/2006
PLUMBING PERMIT APPLICATION
Phone: (509) 688-0036; FAX: (509) 688-0037
For Inspections, Call (509) 688-0054
Project Address: 17221 E Nora Ave Spokane Valley
Owner: Sullivan Homes
Mailing Address: 16114 E Indiana Ave
Contractor: Sturm Heating & Plumbing
4505
Mailing Address:
City
Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Permit Use: Residential
Phone (Daytime Contact): 509-624-4598
State Zip Code
License #: STURMI*210QF
1112 N. Nelson, Spokane WA 99202
Phone #: 325 -
City
State
Zip Code
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
3
X
$6.00
=
2
URINALS
X
$6.00
=
3
TUBS
1
X
$6.00
=
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
3
X
$6.00
=
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
6
X
$6.00
=
6
DISHWASHER
1
X
$6.00
=
7
CLOTHES WASHER
1
X
$6.00
=
8
GARBAGE DISPOSAL
1
X
$6.00
=
9
WATER SOFTENER
X
$6.00
=
10
ELECTRIC HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
$6.00
=
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
X
$6.00
=
12
ROOF DRAINS/OVERFLOW
DRAINS
X
$6.00
=
13
FOUNTAINS, DRINKING
X
$6.00
=
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
X
$6.00
=
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
$6.00
=
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER, HOSE BIB,
STEAMER
PROOFER, CARBONATOR, SWAMP COOLER
3
X
$6.00
=
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE,
AND R.P.B.P.D. FOR: VATS, TANKS, BOILERS
X
$6.00
=
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
$6.00
=
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
$6.00
=
20
MISCELLANEOUS PLUMBING
FIXTURE
X
$6.00
=
21
PRIVATE SEWAGE DISPOSAUSYS
X
$20.00
=
22
INDUSTRIAL WASTE
INTERCEPTOR
X
$15.00
=
METHOD OF PAYMENT:
❑ CASH ❑ CHECK 0 VISA ❑ MASTERCARD
DATE: EXPIRES:
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
MECHANICAL PERMIT APPLICATION
Phone: (509) 688-0036; FAX: (509) 688-0037
For Inspections, CaII (509) 688-0054
Project Address: 17221 E Nora Ave
Owner: Sullivan Homes
Mailing Address: 16114 E. Indiana Ave Spokane Valley WA 99216
Contractor: Sturm Heating and Plumbing
Mailing Address: 1112 N Nelson
99202
Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Permit Use:
Phone (Daytime Contact): 509-624-4598
City
License #: Sturmi*210gf
Spokane
Cit
State Zip Code
Phone #: 325-4505
WA
State
Zi Code
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
1
X
$12.00
=
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/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
1
X
$10.00
=
13
RANGE
X
$10.00
=
14
DRYER
X
$10.00
=
15
FUEL BURNING WATER HEATER
1
X
$10.00
=
16
MISC. FUEL BURNING APPLIANCE
X
$10.00
=
17
GAS PIPING (each outlet)
3
X
$1.00
=
18
DUCT SYSTEMS
1
X
$10.00
=
19
VENTILATING FANS
4
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
1
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
X
$19.00
=
37
INCINERATOR - COMMERCIAL
X
$22.00
=
METHOD OF PAYMENT:
DATE:
❑CASH 0 CHECK 0 VISA 0 MC
SUBTOTAL
PROCESSING FEE
$35.00
CARD #:
EXPIRES:
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE: