2005, 01-18 Permit App: 05000160 Wood Stove ,i`) L 'ent
MECHANICAL PERMIT APPLICATION Community velopment Department
G;;�u� Building Division
'''II^^�''"�Li" Phone: (509) 688-0036; FAX:l(509) 688-0037 11707 E. Sprague Avenue, Suite 106
410/
Ydl /For Inspections, Call (509) 688-0054 Spokane Valley, WA 99206
Project Address: . t o b 20 V'i h p U.'4/ Permit Use:
Owner: ? Ah G. 'c Phor ( aytime Contact): $y?—09 yef
L.
Mailing Address: /5 M S✓/ I'Vti t 'if) , ' PA( i l'lA Pe 14,4 to 1103 7
Cay State Ztp Code
Contractor: )4le_ License#: Phone#:
Mailing Address:
Crty State Zfp Code
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 =
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 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 1 X $25.00 = as---.1A
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: DATE: SUBTOTAL Stb
O
0 CASH 0 CHECK E VISA 0 MC DATE PROCESSING FEE $35.00
CARD#
EXPIRES. TOTAL PERMIT FEE DUE: 0, 00
AUTHORIZED SIGNATURE.