2007, 04-27 Permit App: 07001493 Mechanical Fixtures Permit Center [C�
Stilik „e 11707 E Sprague Ave„S<<:;e 105 `-r /
p ritlll Spokane Valley,WA 99206 ' PERMIT NUMB R:
Valley` (509)688-0036 FAX:(509)688-0037 PERMIT FEE: 5 /
Community Development wwu snokanevalley.or�
Mechanical Permit Application ❑ Commercial +Residential
SITE ADDRESS: /// 2 . . 5 7'/ 14,..5 /t f1
Building Owner
Name:.402.09, Phone: • Fax:
Address: lG 2 U ��` 6 City: 5� State: f�/� Zip: 9�J
7 4
Contractor
l e� 1 1 Phone: Fax: /,
Name: J�!✓if14i!d.,- 44;
4 , f ice./ )/G ��{, 3 3 .0( 7$e 3
Address: c� , .2.2_ j 1/� > City: ��� State: G��r Zip: 4� ! r�
License Nb: ,/e_. J /P hi �.S�041/f City Business Lic:
Contact L ,yam / I
Name:S ,r/v ®P t Pi�e1'/J3/ S Phone: MI', GU ? U
DESCRIPTIONSOF WORK #OF UNITS X COST = TOTAL AMOUNT
1 FUEL BURNING APPLIANCE Equal to or less than 100,000 / X $12.00 = /2
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 =
16 MISC.FUEL BURNING APPLIANCE / X $10.00 = le)
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 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 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 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
EXPIRES:
❑CASH 0 CHECK ❑VISA El/ PROCESSING FEE $35.00
CARD#: 4/44/IN:
TOTAL PERMIT FEE DUE: 19 VIy
AUTHORIZED SIGNATURE: / /
REVISED 8/26/05