2004, 08-04 Permit App: BLD-04-07240 Mechanical Fixturesn
j�
MECHANICAL PERMIT APPLICATION
City of Spokane Valley Community Development Department
BuildingDivision
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
14, FOR INSPECTIONS, CALL (509) 688-0054
Project Addre s: �j O 1 (EI b Ph Si Permit Use:
Owner: ;, t
Mailing Address: /
,/� 1/ City State Zip Code
Contractor: !C L L�Q L/A 22.e A 7 f ii- License #: 1 L N W/�%�X�hone #: +4�6 3 )�.�?/
Mailing Address:!
Phone (Daytime Contact):
C
State
AUTHORIZED SIGNATURE:
Zip Code
DESCRIPTION OF WORK
# OF
UNITS
X
COST
=
TOTAL
MOUNT
A,
1
FUEL BURNING APPLIANCE
Equal to or Tess than 100,000
/
X
X
$15.00
$19.00
=
/
2
FUEL BURNING APPLIANCE
More than 100,000
3
UNLISTED APPLIANCE (Additional Fee)
Equal to or Tess 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
$15.00
=
8
BOILER/REFRIGERATION
101 - 500M BTU
X
$28.00
=
9
BOILER/REFRIGERATION
501 - 1,000M BTU
X
$39.00
=
10
BOILER/REFRIGERATION
1,001 - 1,750M BTU
X
$57.00
=
11
BOILER/REFRIGERATION
More than 1,750M BTU
X
$95.00
=
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
810.00
=
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
819.00
=
22
EVAPORATIVE COOLERS
X
$10.00
=
23
TYPE I HOOD
X
$50.00
=
24
TYPE Il HOOD
X
$10.00
=
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
/
X
$12.00
=
/ 2
26
AIR CONDITIONER
3-15 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
810.00
=
32
WOOD STOVE - FREE STANDING
X
$25.00
=
METHOD OF PAYMENT:
0 CASH 0 CHECK 0 VISA 0 MC
CARD #: r
DATE:
SUBTOTAL
2
PROCESSING FEE
835.00
EXPIRES:
TOTAL PERMIT FEE DUE:
,..-3 '�
n
AUTHORIZED SIGNATURE:
Zip Code