2006, 05-31 Permit App: 06002071 AC `\ reim t Lenter
Spokane 11707 11707 E Sprague Ave,Suite 106j
Valley Spokane Valley,WA 99206 PERMIT NTJRIBER:�¢�
(509)688-0036 FAX (509)688-0037 PERMIT FEE: C
Community Development aw1v.spokanevailev"ore
Mechanical Permit Application ❑ Commercial '® Residential
SITE ADDRESS: I.rZ'2- S J Ant ^.R--*12
Building Owner -so .,( -4 5/4-'Sc,,.1 _ bOt?-cy
Name: Phone: Fax:
Address: City: State: Zip:
Contractor ;
Name: i2o ey_ . .C Rct % L Phone: 4 26� 2Fr FI-i , Fax:
Address: (,' `1 ` S Pe--A 6-J�� City SP- J h yL_`./ State: v„r A Zip:
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License No: City Business Lic:
Contact t2 l�i�• •
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Name: . Phone:
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 400,00D 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 =
B BOILER/REFRIGERATION 101-50DM 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 10,00D 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 1 X $12.00 = 1 2. -vo
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 =
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 11- ""
['CASH 0 CHECK 0 VISA 0 MC EXPIRES: PROCESSING FEE $35.00
CARD#: VIN: TOTAL PERMIT FEE DUE: q? -
AUTHORIZED SIGNATURE: cz }'
REVISED 5/26105