2007, 08-15 Permit App: 07003206 Mechanical Fixtures Permit Center
�i 11707E Sprague Ave,Suite 106
~ Okane PERMIT NUMBER: % ,06
P `� Spokane Valley,WA 99206
�� Valley' (509)688-0036 FAX:(509)688-0037 PERMIT FEE: 7 ,-
Community Development www'.spokanevalley.ore
Mechanical Permit Application [] Commercial ,J Residential
SITE ADDRESS: I LI 1 o3 . " aU( 1t-J
Building Owner
1 lC. ^ Phone: Fax:
Name:
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Address: City: State: Zip:
Contractor
Name: .\f,) . Phone: i 1 Fax: 3 <-
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Address: 5-5-)_ v1't-I.,,,G1 c,✓ City: 0-2). State: w Zip: 15-vZi 2
License No: IVV.., L 99c.-_,-,Jib City Business Lic:
Contact
Name: 1 Phone: c 9 - S 7 9/
DESCRIPTION OF WORK #OF UNITS X COST = TOTAL AMOUNT
1 FUEL BURNING APPLIANCE Equal to or less than 100,000 I X $12.00 = /2 • L`%ti->
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 = .c,z%
18 DUCT SYSTEMS 1 X $10.00 = /,17-. .
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 1 X $12.00 = /2. 07--%
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 $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 3/ cv
['CASH 0 CHECK 0 VISA 0 MC EXPIRES: PROCESSING FEE $35.00
CARD#: VIN: TOTAL PERMIT FEE DUE: 7, cc,
AUTHORIZED SIGNATURE:
REVISED 8/26/05