2009, 04-01 Permit App: 09000813 Mechanical Fixtures MECHANICAL PERMIT APPLICATION Community Development Department
SBuilj^
ding Division
illalky
" Phone: (509) 688-0036; FAX: (509) 688-003711707 E. Sprague Avenue, Suite 106
For Inspections, Call (509) 688-0054 Spokane Valley,WA 99206
C /GZ-erc'L si Permit Use:
Project Addr ss: / Q 7,C j L. _ �-r K
Owner: ant--- L.,„,-,.,2_1,-,_ __ . i-r hone(Daytime Contact):
Mailing Address: -^C, L.14, 47o1 ce
n AA ' 'f� ^ jj City State Zip Code
Contractor: '� '(i. 1%1° / 4 License#: it L-►lift Lit C .l t o K3 Phone#: at 9
Mailing Address: /
City State Zip 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 = /5 `C.3
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 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 = / - 0 0
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 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 X $12.00 =
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 = /r
METHOD OF PAYMENT: SUBTOTAL I(0. o
DATE:
0 CASH 0 CHECK 0 VISA 0 MC PROCESSING FEE
CARD#: EXPIRES: TOTAL PERMIT FEE DUE: 411413C
AUTHORIZED SIGNATURE: