2008, 06-03 Permit App: 08002073 Mechanical Fixtures Permit Center
s �"Aay a Ave,Suite 106 - 90 -;
11707E Sprague PERMIT NUMBER:
Spokane Valley,WA 99206
(509)688-0036 FAX:(509)688-0037 PERMIT FEE: i
Community Development www.spokanevallev.oru r
Mechanical Permit Application ❑ Commercial ID-Residential
SITE ADDRESS: S y 2-I c , (e.. I pt,{ ,,
Building Owner r V kr (. `
Name: 3 j 5"(r i, ` 6I v�U.toc l Phone: 9 7 S:). Fax: -
Address: [ 1 City: State: taljA Zip: `1'I 6
Contractor/3:+. G. 14-Fel'1 o, 7 cd.,,it 3"f R 7- odtiturpiti4,4
Q2 7 4g,96. 1 s0
Name: Phone: Fax:
Address: / L/l(( . e, ÷G,(eta City: Sf flee" State: 1 - Zip: ,. ..a .J yt�t
a
License No: Hpstm City Business Iii e �`✓
Contact /3 ./( ck,..)ilcol ,I 6. :
Name: Phone: 7/u _Z IWOI Ca/
DESCRIPTION OF WORK it OF IRWTS 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 = /,..(. J
3 UNLISTED APPUANCE(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 EVAPORATWE 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 3-15 TON X $20.00 = 74.) .,%
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 c- o()
DCASH 0 CHECK 0 VISA ❑MC EXPIRES: PROCESSING FEE $35.00
CARD# VIN: TOTAL PERMIT FEE DUE: 70,00
AUTHORIZED SIGNATURE:
REVISED 8/26/05