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2011, 09-28 Permit App: 11003054 Piping svarcne....,, 11707 E Sprague Ave,Suite 106 Zv Spokane Valley,WA 99206 PERMIT NUMBER ( S� ��' (509)688-0036 FAX:(509)688-0037 PERMIT FEE: ;8 Community Devettpment wwtiv.stokanevailev.ore Mechanical Permit Application ❑ Commercial [ ] Residential ,,1Q SITE ADDRESS: ( 18 IV \tom 1 r$02--- -/ 51 62, 0‘510s Building Owner j Phone: Fax: Name: "rPO A lA ,bf_I e Iiia(_, (A-) Address: I L I€3 N Vt�iq i-lGt a'} : C_r Ej0$/Coo-, 'p t1_ State: r , ,p Zip: Contractor:.-.. - - N""'• _C, : . 'OM Alf d N:cit 1 Phone: ‘72.- 8- Fax 7 Fax. 9 2 6 ... 6 3 90 Address: A 0, Vit,e, 75-3 C r e r1,Attn .1-65 City: ��er�ifivv P� State: it,4, Zip: ©/ License o: i9/,►2 f�7.3 g,r'�; City Business Lie: /-- a 6 2. 2) //6 Gam • . Contact = Name: Ik..1. } i' _. Phone: CS-en 0-1 0e. /qa",-7ct7). 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 = 6 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 Fx' 'S -t\-1 `/ 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 CONDmONER 0-3 TON X $12.00 = 26 AIR CONDITIONER 3-15 TON X $20.00 = 27 AIR CONDITIONER 15-30 TON X $25.00 = 26 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 SYSTEMSX $12.00 = 35 VENTILATION MECHANICAL EXHAUST X $12.00 = 36 INCINERATOR-RESIDENCE _ X $19.00 = 37 INCINERATOR-COMMERCIALX $22.00 = f METHOD OF PAYMENT: SUBTOTAL // C ❑CASH 0 CHECK 0 VISA 0 MC EXPIRES: PROCESSING FEE $35.00 CARD#: VIN: TOTAL PERMIT FEE DUE: AUTHORIZED SIGNATURE: REVISED Lagos