2007, 09-18 Permit App: 07003715 Mechanical Fixtures Permit Center
S0ka„e 11703E Sprague Ave,Suite B-3 PERMIT NUMBER:
riAcll�' Spokane Valley,WA 99206
jValley` (509)688-0036 FAX:(509)688-0037 PERMIT FEE:
Community Development www.spokanevalley.org
Mechanical Permit Application ❑ Commercial K Residential
SITE ADDRESS: S 1 0 'V r E w. co P n
Building Owner .8 c L f
Name: IP e.
0 Phone:C ( C ) Fax:
Address: 5 I 0) til. K e 11C City. K%)t%E' ll)/l�' State: ( id Zip: fi-/),1/6
Contractor �f
Name: Phone: Fax:
Address: City: State: Zip:
License No: City Business Lic:
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 =
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 1 X $10.00 = I O
14 DRYER 4 X $10.00 = I C
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 = �J
19 VENTILATING FANS '1 X $10.00 = /G
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 J X $12.00 = / ,
26 AIR CONDITIONER 4-15 TON / X $20.00 = at)
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 F c p o By X $12.00 =
36 INCINERATOR-RESIDENCE CITY OF SPOKANE VALLEY., X $19.00 =
37 INCINERATOR-COMMERCIAL X $22.00 =
METHOD OF PAYMENT: EXP EEE r1_ 8 2QQ7 SUBTOTAL
❑CASH CHECK CI VISA I=1 MC t U f PROCESSING FEE $35.00
CARD#: PERMIT CENTEP TOTAL PERMIT FEE DUE: 44k1-„2.
AUTHORIZED SIGNATURE: BY:
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REVISED 8/26/05