2009, 12-08 Permit App: 09003870 Mechanical Fixture RECEIVED 12/08/2009 13:43 5098880037 SV PERMIT CENTERFR
12/08/2009 13:51 5099243819 AIR CONTROL PAGE 01/01
S5P 09 2005 15,:12 FR IU 9243819 P,02fee
PermitG•e C1 4CO E'`1Y - 3 C'0�L ».
11107 E S• pee,Suite 106 _ ?E1 1T NUMBER:
Spokane Valley.WA 49206 -....1(509)685-0036 FAX:(500)683-0037 PERMIT FEE:
Community Development wwKp);,lgw.nra.cam
Mechanical Permit�i.pplication "/❑Commercial 1,,Residential
..._ ....
..
Sulldly:owner
Nom: .�7'�./ ���/// ' Phone: _At -A 'F._ `t 2 -Q Fax
-Address: ___qa,7 , CI . �• ,t �. zi �ZZ-
Contractor •
Noma: e„ 14_t Phc,e: q . --,11 b 7 rax:'Z, -- . 'VI
Address: 710 3 L`'. A/40, '6 ✓''P- Ci ,m.,,
Q'L1 stats A' z(, . .�;2
License No: 4 R r,4 O57rtCity sucinetsLicefst N0: ,.
C.nntnet
Name: Ii/L4--X 6) /
DESCRIPTION OF WORK _ . 8 OF IJN(TS X COST ■ TOTAL AMC-Mr
1 FUEL BURNING APPLIANCE Equal to or late Itta 100.000 $12.00 = 1
2 FUEL BURNING APPLIANCE Mora than 100,000 X $16.00
3 UNLISTED APPLIANCE(Additional Feel Equol to or lana than 400,000_...__. X SO 00
4 UNLISTED APPLIANC1JAdditlnnal Foo) More than 400,000 - X '5100.90 -
5 , USED APPLIANCE(WSEC min.AFUE rating) EqualJO or leas Than 400.000 . ,. X $60.00
6USED APPLIANCE{WSSC min.AFUE rnUn- Moro tha 400,000 X 5100.00 _„
7 BOILER/REFRIGERATION 1.100M BTU X $12.00 im
a . BOILER/REFRIGERATION 101.600M BTU X $20.00 a
a . Ma/REFRIGERATION • .401 j,000M BTU X $26.00 e
10 BDILERIREPRIGERATION 1,001-1.750M BTU X $3500 =
11 BOILER/FtEFRlGERATION More than 1,7SOM BTU X• 360,00 - •,
12 GAS LOG,GAS INSERT,GAS FIPLEE, X $000 K
13 RANGE X 510.00 R
14., DRYER .. X 310.00 =
IS FUEL BURNING WATER HEATER X $10.00 n
i 16 MISC.FUEL B - ING APPLL_.C- _.. X 510.00 =
17 GAS PIPING(omen outlet) X $1.00 n
18 DUCT SYSTEMS X $10.00 =
10 VENTILATING FANS X $10.00 = -
20 AIR HANDLER(DOES NOT Include ducting& E.ual to or less than 10 000 Ch=M _ _ X $1.00 ,_-_,
21 AIR HANDLER(DOES NOT Include auclln2L. Greater then 10,000 CFM X • 310.00 , r
22 EVAPORATIVE COOLER$ X 510,00
23 TYPE Q0 - .
(, X , $50.00. =
24 TYPE Il HOOD X $10.00 n
25 _ HEAT PUMP/AIR CONOITIONER 0-$TON X t1#03 n
26 AIR CONDITIONER 3-15 • X $20,00 r.
27 AIR CONDITIONER 15.30 TON X $26.00 =
t.20 AIR CONDITIONER 30.50 TON - X. $35.00 =
20; AIR CONDITIONER More than 50 TONX 360,00 ms=µ
30 LPG STORAGE TANK X 310.00 =
31 , WOOD OR PELLET s7OvE/INSEJT x $10.00 *,
32 WOOD S OVE-FREE STANDING X t2S,op =.
33 REPAIR&ADDi1'IONS X $15.00 •
34 VENTILATION SYSTEMS x 512.00 =
36 VENTILATION MECHANICAL EXHAUST X $12.00 >•
36 INCINERATOR-RESIDENCE. _ . X $19.00 =
37 + INCINERATOR-.COMMERCIAL X $22.00 = r�
METHOD OP PAYMENT: G .
SURTOTAL • /
❑CASH .❑01.150 YO DATE: PROCESSING FEE ��/5535.00
CARD . EXPIRES! TOTAL.PE, '7
MI7 FEE DUE: "7i c�t,+.
1,
AUT,HORIZE'D SIGNATURE: 4 Aavrso modes
This document originally contained kac TOTAL PAGE.02 0f :k I�
confidential credit card information which
was redacted pursuant to RCW 19.255.010
and the original document destroyed
pursuant to SOS DAN GS2014-030.