2010, 12-07 Permit App: 10003979 Mechanical FixturesPermit Center
11707E Sprague Ave, Suite B-3
\ d �.� Spokane Valley, WA 99206
��AA��11CC��'' 009)6$88-0076 FAX: (509)568-0037
Community Development Wwi�p telaa )tom
Mechanical Permit Application
SITE ADDRESS
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Name
Address:
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DESCRIPTION OF WORK
UNLISTED APPLIANCE Additional Fee
UNLISTED APPLIANCE Additional Fee
USED APPLIANCE SEC min. AFUE rutin.
USEDAPPLOWCE SEC min, AFUtr ra6n •
BOILER/REPRICE-RATION
B OILER/REFRIGERATION
BOILER/REFRIGERATION
E • ual to oc leas Man 100,000
Moro titan 100 000
E. ust to or less man 400 000
More tit^400,4.00
E•ual mor less Olen 4i.a•.•0
More Than 400.000
1- IOOM GTV
BOILER/RCFI? TION
BOILER/REFRIGERATION ~~
GAS LOG GAS INSERT, GAS FIREPLACE
RANGE
DRYER
FUEL BURNING WATER NEATER
MISC, FUEL BURNING APPLIANCE
GAS PIPING each owlet
DUCTSYSTEMS
VENTILATING FANS
l0t-5OOM6TU
501 • 1,000M BTU
1001-1,750M BTU
More than 1 750M BTU
#OF UNITS
AIR HANDLER OES NOT include ductal
AIR HANDLER DOES NOT include dyctfn
EVAPORATIVE COO -5
TYPEIHOOD
TYPE II HOOD
HEAT PVMP/AIR CONDITIONER
AIR CONDITIONER
3109.00
$50.00
$100.00
312.00
$20,00
$25.00
$35.00
60.00
310.00
310.00
$10,017
$10.00
310,00
$1,00
510.00
$10.00
$12.00
315,00
310,00
350.00
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONEL_
LPG STORAGE TANK
4-15 TON
15-30 TON
30.50 TON
More Otani $0 TON
WOOD OR PELLET STOVE/INSERT
WOOD STOVE - FREE STANDING
REPAIR 8 ADDITIONS
VENTILATION SYSTEMS
VENTILATION MECHANICAL EXHAUST
INCINERATOR—RESIDENCE
INCINERATOR —COMMERCIAL
METHOD OF PAYMENT;
OCASH p CF gREI a ACTED EXPIRES: • J�
CARD 1t: . �R(G� UVJ � . f LI '-' PROCESSING PEE
AUTI-IORIZI;D SIGNATURE': TOTAL PERMIT FEE DUE:
k6vIfED drzanf c./ �/� e� j�j,�hj eJ ��U „_ r, -
SUBTOTAL
335.00
350.00
310.00
$10.00
325,00
$15.00
312.00
312.00
$19.00
322.00
Received Time Dec. 7. 2010 3:28PM No. 0210
This document originally contained
confidential credit card information which
was redacted pursuant to RCW 19.255.010
and the original document destroyed
pursuant to SOS DAN GS2014-030.