2005, 01-24 Permit App: 05000214 Furnace, Piping , 05. — I (f'
/'` MECHANICAL PERMIT APPLICATION Community Development Department
*lune\ Building Division
"a' Phone: (509) 688-0036; FAX:-(509) 688-0037 11707 E. Sprague Avenue, Suite 106
For Inspections, Call (509) 688-0054 Spokane Valley, WA 99206
Project Address: �. ' ,4,. ^. Permit Use: C-e-
Owner Il :RA I.. Phone (Dayti e Contact : ( ac . a "t, era JQ
Mailing Address: f-
Mailing l r7 I ISL fi' Tok(A46.41 1�
Uq L/i. r4 `0'
ity State Zip ode
Contractor: License#: Phone#:
Mailing Address:
City State Zip Code
DESCRIPTION OF WORK *OF UNITS X COST = TOTAL AMOUNT
1 FUEL BURNING APPLIANCE Equal to or less than 100,000i X $12 00 = 2.00
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) f X $1.00 /= • OD
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 O-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 STOVEJINSERT , 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
0 CASH 0 CHECK 0 VISA ❑MC DATE PROCESSING FEE ...,.Sd'S00
EXPIRES:
CARD# TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE.
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