2005, 02-17 Permit App: 05000505 Furnace, PipingL p.
MECHANICAL PERMIT APPLICATION
Phone: (509) 688-0036; FAX: (509) 688-0037
For Inspections, CaII (509) 688-0054
Project Address: .3 6 o q I. . 74 2 1 d
Owner: M.-.- H N 1 ,0iA 4
Mailing Address: 1-7 1 S S. S . Aei Pm4,•�k 1-)f
Contractor: / '
Mail'nq Address:
Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Permit Use: /
Phone (Daytime Contact): GIG' - 7 3,S- "7
Oz?ad.el�t l.Ja lRo3`7
Stale Zip Code
�� --� License #: Phone #:
tate
Zip Code
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
,4-0.1 opt)
X
312.00
=
(2-00
2
FUEL BURNING APPLIANCE
More than 100,000
X
315.00
=
3
UNLISTED APPLIANCE (Additional Fee)
Equal to or less than 400,000
X
350.00
=
4
UNLISTED APPLIANCE (Additional Fee)
More than 400,000
X
3100.00
=
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
3100.00
=
7
BOILER/REFRIGERATION
1 - 100M BTU
X
312.00
=
8
BOILER/REFRIGERATION
101 - 500M BTU
X
320.00
=
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
360.00
=
12
GAS LOG, GAS INSERT, GAS FIREPLACE
X
310.00
=
13
RANGE
X
510.00
=
14
DRYER
X
310.00
=
15
FUEL BURNING WATER HEATER
X
310.00
=
16
MISC. FUEL BURNING APPLIANCE
X
310.00
=
17
GAS PIPING (each outlet)
X
$1.00
=
18
DUCT SYSTEMS
X
$10.00
=
19
VENTILATING FANS
X
510.00
=
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
310.00
=
23
TYPE I HOOD
X
$50.00
=
24
TYPE II HOOD
X
310.00
=
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
X
312.00
=
26
.AIR CONDITIONER
3-15 TON
X
320.00
=
27
AIR CONDITIONER
15-30 TON
X
325.00
=
28
AIR CONDITIONER
30-50 TON
X
335.00
=
29
AIR CONDITIONER
More than 50 TON
X
360.00
=
30
LPG STORAGE TANK
X
310.00
=
31
WOOD OR PELLET STOVE/INSERT
X
310.00
=
32
WOOD STOVE - FREE STANDING
X
$25.00
=
33
REPAIR & ADDITIONS
•
X
315.00
=
34
VENTILATION SYSTEMS
X
312.00
=
35
VENTILATION MECHANICAL EXHAUST
X
312.00
=
36
INCINERATOR - RESIDENCE
X
319.00
=
37
INCINERATOR - COMMERCIAL
X
322.00
=
METHOD OF PAYMENT:
❑ CASH 0 CHECK 0 VISA 0 MC
CARD A'•-
DATE:
SUBTOTAL
IR -.00
PROCESSING FEE
335.00
EXPIRES:
TOTAL PERMIT FEE DUE:
( '-(/7 • O� \ J
AUTHORIZED SIGNATURE: