2012, 05-17 Permit App: BLD-2012-0671 Mechanical FixturesER
aizeyT T T ._.
Community Development
N echanic tI Permit
Permit Center
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
www.spokaneva!lev.ore.com
Application
SITE ADDRESS 11 3c).()Li
PERMIT NUMBER:
PERMIT FEE:
❑
Commercial (Residential
Building owner
Name: \ ii S Xi 1 li0'A.j't t A) (y\ } MOr:,
Phone:
' ,--1tt 2) 4.7f1{ \t,„. Fax
l' ?i:4 - t i if
Address: h +-1,3 S 'V\ ((t Y , 1 & 1
City 4 s t S State
i r Zip 'rY :::i�i
`,-2
Contractor
`
y
Name: Y,.- iii NSW; t1
Phone:
Fax:
Address: `
City State
Zip
License No:
City Business License No:
Contact
Name:
Phone:
DESCRIPTION OF WORK
# OF UNITS
X
COST
- TOTAL AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
X
$12.00
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
USEDAPPLIANCE (WSEC min. AFUE rating)
Equal to or less than 400,000
X
050.00
6
USED APPLIANCE (WSEC min. AFUE rating)
More than 400,000
X
$100.00
7
BOILER/REFRIGERATION
1 - 100M BTU
X
$12.00
8
9
10
BOILER/REFRIGERATION
101 - 500M BTU
BOILER/REFRIGERATION
501 - 1,000M BTU
BOILER/REFRIGERATION
1,001 - 1,750M BTU
X
X
X
$20.00
$25.00
$35.00
11
BOILER/REFRIGERATION
More than 1,750M BTU
X
$60.00
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
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
012.00
36
INCINERATOR - RESIDENCE
37
INCINERATOR - COMMERCIAL
X
X
$19.00
022.00
METHOD OF PAYMENT:
❑CASH ❑ CHECK ❑ VISA ❑ MC
CARD #:
AUTHORIZED SIGNATURE:
DATE:
EXPIRES'
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
REVISED 6/26/05