2004, 11-04 Permit App: 04009015 Furnace, Piping 0 4 •-- Cf 0/5----
.SlMECHANICAL PERMIT APPLICATION
e City of Spokane Valley Corn`rnunity Development Department
.,,,,Valley Bull�ngDivision
f f 707 E. Sprague Avenue, Suite 106
. Spokane Valley, WA 99206
Phone: (509)688.0036;Fax: (509) 688-0037
FOR INSPECTIONS,.CALL.(509) 688-0054
Project Address: 7 6 ,��//� ��
I�J S - Permit Use:
'Owner.. v I c 7u)S2P✓] ,I<"() Phone(Daytime Contact): -Mg 99.5 7y 3
'.Mailing Address: s .- i,ri
•
State .
Contractor: License#: City Phone#: Zip code
Mailing Address:
City _ - State Zip Code
DESCRIPTION OF WORK #OF TOTAL
UNITS X • COST • _ I AMOUNT
1 FUEL BURNING APPLIANCE Equal to or less than 100,000 4 X $15.00 , _
mare man 100,000 ' X $18.00 _
3 UNLISTED APPLIANCE(Additional Fee) X $50.00 =
Equal to or less than 400,000 {
4 UNLISTED APPLIANCE(Additional Fee) • More than 400,000 X $100.00 =
USED APPLIANCE(WSEC min.AFUE
5 rating Equal to or less than 400,000 • X $50.00 = .
USW APPLIANCE(WSEC min AFUE
6 rating) More than 400,000 . X $100.00 =
7 BOLLER/REFRIGERATION 1-100M BTU • ' X $15.00 1 = _
E BOILER/REFRIGERATION 101-500M BTU X $28.00 = '
9 BORER/REFRIGERATION 501-1,000M BTU X $39.00 =
10 BOILER/REFRIGERATION 1,001-1,750M BTU X $57.00 ' _
It BOILEIVREFRIGERATION More than 1,750M BTU X _ $95.00 =i •
•
f2 GAS LOG,GAS INSERT,GAS FIREPLACE • X $10.00 =
13 RANGE
X $10.00 =
14 DRYER -- X _ $10.00 = T
15 FUEL BURNING WATER HEATER 1 X 110.00
• 18 MISC.FUEL BURNING APPLIANCE F X $10.00. _.
17 GAS PIPING(each outlet) C)l i if
2I f)I�rt5 .2 X $1.0.0 _
1 _ ,�u
IS DUCT SYSTEMS X 510.00 • =
19 VENTILATING FANS•
X $10.00 = _
20 AIR HANDLER(DOES NOT include ducting) Equal to or less than 10,000 CFM 1 `
X 51200 =
21 AIR HANDLER(DOES NOT Include-ducting) Greater than 10,000 CFM X $19.00 = f'
22 EVAPORATIVE COOLERS
' X $10.00 =
23 TYPE 1 HOOD •
X' $50 00 =
24 TYPE It HOOD
X ' $10.00 =
25 MEAT PUMP/AIRCONDITIONER • • $3 N TO • •
X $12.00 -
-
26 AIR GOND ONER 3-15 TON .
L25_, $20.00 x
' -+R-CONO/TI RER 10-30TON " X ` $25.00 =
_28 AIR CONI)ITIONE_R 30-5o TON
X $35.00 = '
29 AIR CONDITIONER More than 50 TON • X ' _ ��
� 560.00
30 LPG STORAGE TANK . '
• X $10.00 =
31 WOOD OR PELLET STOVE/INSERT _
X, 510.00 . x1 _
32 WOOD STOVE-FREE STANDING
' X 525.00 =
METHOD OF PAYMENT: SUBTOTAL
•
Q CASH 0 CHECK 0 VISA 0 MC DATE: PROCESSING FEE
$35.00
CARD#: EXPIRES:
TOTALPERMl1-FEE DUE
AUTHORIZED SIGNATURE: V