2008, 03-04 Permit App: 08000679 Water Heater Permit Center i
Spokane
11703E Sprague Ave,Suite B-3
Spokane Valley,WA 99206 PERMIT NUMBER:•
(509)688-0036 FAX:(509)688-0037 PERMIT FEE:
Community Development www.spokanevallev.org
Mechanical Permit Application/ ❑ Commercial DK Residential
SITE ADDRESS: / j.9 .i S �
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Building Owner (.� _7 C�t.t�11`Ql`C./
Name: U No. Phone: i 9 j^ D q Fax: y� G�
" City [ State: (�.,> OT Zip: (�Z I
Address: y 5/Z r f l -SCYZiVyyfd"(/,ci : �ipp��
Contractor - 1 - Q ` �i
Name: �e fil• erl <� "f�4 �1 PhonC,g -4, ®&O(e7 Fax: g> 7 6,q q J 23
Address: b 12 w 1 .[J�. City. .)i - State: ,3 Zip:�.-5' R<<f
License No: // SGS Y� City Business Lic: T
Contactiv
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Name: e.Jtv' h7 C ie Phone (M �-�I) (c c -(.5 (14 c y Z�4 7,8
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 RANGE X $10.00 =
14 DRYER _ X $10.00 =
15 FUEL BURNING WATER HEATER X $10.00 = /0.
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 EVAPORATIVE COOLERSX $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 4-15 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 TANKX $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 /0-°4-5
O4-5
EXPIRES: PROCESSING FEE $35.00
❑CASH 0 CHECK ❑VISA 0 MC
VIN: TOTAL PERMIT FEE DUE: d
CARD#:
AUTHORIZED SIGNATURE:
Effective 10-28-07 P:\Community Devdopment\Fonns'Building forms\Mechanical Permit Applicationdoc