2006, 01-20 Permit App: 06000152 Furnace MECHANICAL PERMIT APPLICATION 1 S ^ Community Development Department
• Capecif....
- p Building Division
X7 1ley Phone: (509) 688-0036; FAX: ( .19) 688-0037 11707 E. Sprague Avenue, Suite 106
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For Inspections, Call (509) 688-0054/ /f Spokane Valley, WA 99206
Project Addres : /S S - U (i2 'I till et. CN • Permit Use: ,Y`�'( '( (7> ki)-( -k /�
Owner. _ �- Phon Daytime Contact): VW* •
Mailing Address: _ J - . I i✓1 i C. L-- - P Uc L . k 2 D G
' q r_ i. ,,yy�� State Zip Code
Contractor: + C •
l • a��' A License#: , S�'�-Phone#: Z?- / '�/a -7 ZY6
Mailing Address: i ([/a 6 . c I SP 0/Call-C. 0 !Z/ LU ' 2/
Cityt. State Zip Code
DESCRIPTION OF WORK . #OF UNITS X COST = TOTAL AMOUNT
1 FUEL BURNING APPLIANCE Equal to or less than 100,000 r X $12.00 = / Z ' 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 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 1 -b
0 CASH 0 CHECK 0 VISA 0 MC DATE: PROCESSING FEE $35.00
CARD#: EXPIRES: TOTAL PERMIT FEE DUE: 2/7- DO
AUTHORIZED SIGNATURE: