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2007, 10-11 Permit App: 07004084 Gas Appliance Permit Center 1 - Cfil7>�._.e 11703 E Sprague Ave,Suite B-3 (, '( Spokane Valley,WA 99206 PERMIT NUMBER: Valler (509)688-0036 FAX:(509)688-0037 PERMIT FEE: - 1 Community Development L9ww•spokanevallev.ore Mechanical Permit Application ❑ Commercial `Residential l 1 SITE ADDRESS: ____6- Z -s-c.3- : '?\ ca,6 l 1 N Building Owner Name: Phone: Fax: Address: ��- ', (141,e I1� City:�'^y.s�C�w`� 04)�; tate: CA ) /}, Zip: Contractor - 3 V l `� Name: rr Phone: Fax: Address: pCi State: w A. Zi License No: ��2- ev 61, n 1. .,r! B City Business Lic: 6 ei i C jy Contact /� lll��C Name:4l/ f ( 1 ) Phone: 9 J!: l(-- j Z DESCRIPTION OF WORK #OF UNITS X` COST = TOTAL AMOUNT 1 FUEL BURNING APPLIANCE Equal to or less than 100,000 '? 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 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 4-15 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 I $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: SUBTOTAL ❑CASH 0 CHECK 0 VISA MC EXPIRES: PROCESSING FEE $35.00 CARD#: V :, TOTAL PERMIT FEE DUE: AUTHORIZED SIGNATURE: QQ4),, ''`h REVISED 8/26/05 J