HomeMy WebLinkAbout2006, 12-11 Permit App: 06004794 Insert s'- Permit Center (�` \ , ; .: A �
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e �"`" 11707 E Sprague Ave,S'.L.-1 la, !! 1 C' i f ' l`. .‘t
xd11e' Spokane Valley,WA 99' I �� ! PERMIT NUMBER:
(509)688-0036 FAX:(51`)6:8(0037 1- PERMIT FEE:
Community Development
Mechanical Permit Application (�:;`, [gVomm•rlifcaal •sidential
STlE ADDRESS: ' / 1 1 CO WaFt I L� 1 I. . '�' • UCL 4'Lf l.C..)! 7 q`7 c2Q�
Bim.Owner
Name: "r,Q.,�r(-11�- f� `"Q�./ Phone: 5 DC/-� ?( Jy dd3 : jN/4 (�/�
Address: 1 7 1( 1 V i.C/a ( F- _ City: �!`�7 (J ! vU-(\ 74C,7 a 6
Contractor--_ _ _ _ l'
Name: Sn "T-'
t r_ Phone: Fax:
Address: i� City: State: Zip:
License No: ` a v City Business Lic:
Contact f""'
Name: Phone:
DESCRIPTION OF WORK 0 OF UMTS 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 (BILIS 11U APPLIANCE(Add doral Fee) Equal to or less than 400,000 X 00 __
4 UNLISTED APPLIANCE(Adthbonai 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 ruin.AFUE rating) More than 400,000 , X . 000.00
7 BOILER/REFRIGERATION 1-100M BTU X -41"'14 =
•
8 BOEERIREFRIGERATION 101-500M BTU X *00 =
9 BOLER/REFRIGERATION 501-1,000M BTU • X 0 =
10 BOILER/REFRIGERATION 1,001-1,750M BTU X WOO _
11 BOILER/REFRIGERATION More than 1,750M BTU -f- X $60: 1 =
12 GAS LOG,GAS INSERT,GAS FIREPLACE / _ X $10.00 = lQ
13 RANGE X $10.00 =
I
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 dueling) Equal b or less than 10,000 CFM X $12.00 =
21 AIR HANDLER(DOES NOT include eluding) Greater than 10,000 CFM X $15.00 =
22 EVAPORATIVE COOLERS X $10.00 =
23 TYPE I HOOD X $50.00 =
24 TYPE If 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 STOVEJINSERT X $10.00 =
32 WOOD SVIVE-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
DCASH ❑CHECK 0 VISA ❑MC EXPIRES: PROCESSING FEE $35.00
CARD#: VIN: TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
REVISED 8/26/05