2007, 04-19 Permit App: 07001346 Piping k
Permit Center
s�_" 11707E Sprague Ave,Suite 106 PERMIT NUMBS
'�alle 3�
y Spokane Valley,WA 99206
(509)688-0036 FAX:(509)688-0037 PERMIT FEE:
Community Development www.spokanevallev.org 1 �'
Mechanical Permit Application ❑ Commercial ►„ Residential
SITE ADDRESS: 2(6c.-- 1J - v t S rA
Building Owner f,-)) c l..) C v,.(.'
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Name: (
Phone: ( _(/So SFax:
Address: q6. U 3 X) U r'J4r, City: Sp) /C1/T- 0 a/ te: w jZip: g q r j
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Contractor ', C._ .tai- A/ c F-1 C
Name:
Phone: Fax:
y Address: 4 ; City CCt(A_p Ut ffrStatetA jUJ ziP:F'271,;
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License No: / c F`i- 0 AA no 3 City Business Lic:
Contact *j.1( c IA ci rtcIA 11
Name: Phone: -7/0 ,__Z (16,_Z c-.10( (
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 =
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 Bill 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 APPLIANCEX $10.00 =
17 GAS PIPING(each outlet) t 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 COOLERSX $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 g 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
❑CASH CHECK 0 VISA 0 MC EXPIRES: PROCESSING FEE $35.00
CARD#. VIN: TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
REVISED 8!26/05 Tyv�
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