2007, 03-27 Permit App: 07000975 Gas PipingPermit Center
S�.7'A„ 11707 E Sprague Ave, Suite 106 PERMIT NUMBER:
pokane Spokane Valley, WA 99206
:Valleys (509)688-0036 FAX: (509)688-0037 PERMIT FEE:
.Oowww spokanevallev.ore
Community Development
Mechanical Permit Application ❑ Commercial esidential
SITE ADDRESS: -32-2- ,Ji��I riESi'rs7 -
Building Owner
DESCRIPTION OF WORK
Name:
Phone: .7
Fax:
Address: t /,T
City:
State: Ce -7A Zip: 4
Contractor
2
FUEL BURNING APPLIANCE
Name:
Phone:
Fax:
Address:
City: � OkA -1-i—
State: Zip: 5'7�
License No:
City Business Lic:
4
Contact
More than 400,000
X
Name:
Phone: 2 U / (-3
USED APPLIANCE SEC min. AFUE rating)
DESCRIPTION OF WORK
# OF UNITS X
COST I= TOTAL AMUUN I
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 SEC min. AFUE rating)
Equal to or less than 400,000
X
$50.00 -
6
USED APPLIANCE SEC 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 =
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
21
AIR HANDLER DOES NOT include ducting)
Greater than 10,000 CFM
22
EVAPORATIVE COOLERS
23
TYPE I HOOD
I
24
TYPE II HOOD
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
26
AIR CONDITIONER
4-15 TON
27
AIR CONDITIONER
15-30 TON
/
U
28
AIR CONDITIONER
30-50 TON
29
AIR CONDITIONER
More than 50 TON
30
31
LPG STORAGE TANKrr-
WOOD OR PELLET STOVE/INSERT
32
WOOD STOVE - FREE STANDING
33
REPAIR & ADDITIONS
34
VENTILATION SYSTEMS
35
VENTILATION MECHANICAL EXHAUST
36
INCINERATOR - RESIDENCE
37
INCINERATOR - COMMERCIAL
METHOD OF PAYMENT:
......
[]CASH ❑ CHECK ❑ VISA ❑ MC
EXPIRES:
PROCESSING FEE $35.00
CARD #:
VIN:
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
REVISED 8/26105