2005, 06-09 Permit App: 05001866 Furnace, Piping MECHANICAL PERMIT APPLICATION
S"pokane01/1/1\ City of Spokane Valley Community Development Department
BuildingDivision
Dalley 11707 E. Sprague Avenue, Suite 106
400*
Spokane Valley, WA 99206
Phone: (509) 688-0036;Fax: (509) 688-0037
FOR INSPECTIONS, CALL(509) 688-0054
Project Address: S, a5//6 Permit Use:
Owner: 6." e • 4-..i. i// Phone Daytime Contact): gal- '779,2.
Mailing
79-
Mailing Address:' S S . -9/G (./ixt;k • SpI(d,va- V 1 cr/R - 99aa6
City State Zip Code
Contractor: RAMS-(2, o n) rS SNEET ryiET 'r License#: th LSm/S'p IIZ Phone#: 9a$-094a
Mailing Address: k-, /3 ?o3 7'RE,t/T S'pakane f/oJIe A I,wf+• 99x/6
City State Zip Code
#OF TOTAL
DESCRIPTION OF WORK UNITS X COST = AMOUNT
1 FUEL BURNING APPLIANCE Equal to or less than 100,000 I X $15.00 = ( Z' C
2 FUEL BURNING APPLIANCE More than 100,000 X $19.00 =
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 =
USED APPLIANCE(WSEC min.AFUE
5 rating) Equal to or less than 400,000 X $50.00 =
USED APPLIANCE(WSEC min.AFUE
6 rating) More than 400,000 X $100.00 =
7 BOILER/REFRIGERATION 1-100M BTU X $15.00 =
8 BOILER/REFRIGERATION 101 -500M BTU _X $28.00 =
9 BOILER/REFRIGERATION 501-1,000M BTU X $39.00 =
10 BOILER/REFRIGERATION 1,001 -1,750M BTU X $57.00 =
11 BOILER/REFRIGERATION More than 1,750M BTU X $95.00 =
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) 3 X $1.00 = J. a o
18 DUCT SYSTEMS X $10.00 =
19 VENTILATING FANSX $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 $19.00 =
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 3-15 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 =
METHOD OF PAYMENT: SUBTOTAL /9 , oy
DATE:
0 CASH 0 CHECK 0 VISA 0 MC PROCESSING FEE $35.00
CARD#: EXPIRES: TOTAL PERMIT FEE DUE: S
AUTHORIZED SIGNATURE: