2006, 05-09 Permit App: 06001737 Heat Pump MECHANICAL PERMIT APPLICATION / Community Development Department
J Building Division
Jlth
Phone: (509) 688-0036;FAX: (509) 688-003711707 E.Sprague Avenue, Suite 106
For Inspections, Call(509) 688-04541 Spokane Valley,WA 99206
Project Address: 1 S C Ie s,..re ta 1 if( LK) ' Permit Use: Add v-frt. c-
Owner: a i , A �.aaPhone(Da Te
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ntact):, a / '' '.St /
Mailing Address: / q/f 44-or V,--41 i ('"Zr ` " c,Aw' c�J / cc / State tip
code
Contractor4 r Q 0,-d .11 c` License#: r- iw (� iI,1 .� Phone
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Mailing Address: i / Y1 2 , C.,t. z f : .S. L) `Q eta U' -( c.._1fft• ff v./�City State p Code
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 RANGEX $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 ducfmq) Greater than 10,000 CFM X $15.00 =
22 EVAPORATIVE COOLERS X $10.00 =
23 TYPE I HOOD X $50.00 =
24 TYPE II HOODX $10.00 =
25 HEAT PUMP/AIR CONDITIONER 0.3 TON t X $12.00 = / 2 M U C,
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 $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 r . 0+
0 CASH 0 CHECK 0 VISA O MC DATE: PROCESSING FEE $35.00
CARD#: EXPIRES: TOTAL PERMIT FEE DUE: ettr JO
AUTHORIZED SIGNATURE