2009, 02-06 Permit App: 09000249 Mechanical Fixtures Permit Centerarralley � �
11707 E Sprague Ave,Suite 106
Spokane Valley,WA 99206 9.�" !1,/ PERMIT NUMBER:
�� (509)688-0036 FAX:(509)688-0037 1,O PERMIT FEE:
Community Development www.sookanevallev org .
Mechanical Permit Application ❑ Commercial laRtgidential
SITE ADDRESS: ;
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Bpil owner I, )c K 4' Deb (sbi.e -c H
Name: Phone: Z y-Z Fax
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Address: g�V N . 1/ts f-0- _ city:S)ueor . Uc1(eel Stalml"-iif : t'Q z( Z
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Name Phone:q 7_taw� Fax- S0*"/t Address 1 IN(Z . C.c.-t-z.,(tom City: 1 Klklfs , State: ZIP: 4 c'ef,
license No: gc, 6 AA-0s,0 ?soli i I City Business Lic
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Name: Prion -7/U _2.'VG C of/
DESCRIPTION OF WORK #OF UNITS X COST = TOTAL AMOUNT
1 FUEL BURNING APPLIANCE Equal to or less than 100,000 X $1200 = l'e° t'L
2 FUEL BURNING APPUANCE More than 100.000 / X $15.00 = lam• 0 0
3 UNLISTED APPUANCE(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 =
8 USED APPLIANCE(WSEC min.AFUE rating) More than 400.000 X $100.00 =
7 BOI TION 1-100M BTU X $12.00 =
8 BOILER/REFRIGERATION 101-500M BTU X $20.00 =
9 TION 501-1.000M BTU X $25.00 =
10 BOILER/REFRIGERATION 1.001-1,750M BTU X $35.00 = -
11 BOILER/REFRIGERATION Mom 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 =-
18 MISC.FUEL BURNING APPLIANCE X $10.00 =
17 GAS PIPING(each outlet) ,� X $1.00 =
18 DUCT SYSTEMS / X $10.00 = /"a
19 VENTILATING FANS ( X $10.00 =
20 AIR HANDLER(DOES NOT include ducting) Equal to or less than 10.000 CFM X $1200 =
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 = Z 0
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 (-7.Z. 0 O
OCASH 0 CHECK 0 VISA 0 MC EXPIRES: PROCESSING FEE $35.00
CARD 4: VIN: TOTAL PERMIT FEE DUE: F/ . ot1
.._IO,,rZED SIGNATURE..
REVISED$l261U5 - -_- ---