2004, 05-20 Permit App: BLD-04-04398 Furnace, Piping MECHANICAL PERMIT APPLICATION
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3pohane City of Spokane Valley Community Development Department
BuildingDivision
ley
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
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Phone: (509)688-0036;Fax: (509) 688-0037
FOR INSPECTIONS, CALL(509) 688-0054
Project Address: tI W.)S N 1/./s7 4 Permit Use:
Owner: e-i6 'PAL-L-Gu Phone(Daytime Contact):
Mailing Address:
City State Zip Code
Contractor: SAi,a„.( e,,,. „,r -5'i ""} /NC- License#: $POI4CS 9Y7A 4 Phone#: 32.'7'-JkFY-
Mailing Address: 2G 7 s. A-.5/-f--n,,,, 64ft4J,vcitf1 W-1- 9 .c/L
City State Zip Code
#OF ' TOTAL
DESCRIPTION OF WORK UNITS X COST = AMOUNT
1 FUEL BURNING APPLIANCE Equal to or less than 100,000 / X , $15.00 = /r• U
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 fess than 400,000 X $50.00 =
USED APPLIANCE(WSEC min.AFUE
6 rating) More than 400,000 X $100.00 =
7 BOILERIREFRIGERATION 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) / X $1.00 = / - CO
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 $19.00 =
22 EVAPORATIVE COOLERS X $10.00 =
23 TYPE I HOOD X $50.00 =
h
24 TYPE It HOOD X $10.00 =
25 HEATPUMP/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 rr WOOD STOVE-FREE STANDING X $25.00 =
METHOD OF PAYMENT: SUBTOTAL I i - 0 0
❑CASH 0 CHECK 0 VISA CI MC DATE: PROCESSING FEE $35.00
CARD#: EXPIRES: TOTAL PERMIT FEE DUE: £7 • 0 0
AUTHORIZED SIGNATURE: