2008, 12-05 Permit App: 08004717 Mechanical Fixtures .../'\ Permit Center
S Off a a _,•
11703 E Sprague Ave,Suite B-3 PERMIT NUMBER: �,I I•k
P ri�i`ll�' Spokane Valley,WA 99206
jValley` (509)688-0036 FAX:(509)688-0037 PERMIT FEE: 1_4 66 --
Community Development permitcenter@spokanevalley.org
Mechanical Permit Application /I-
Building
�/ n Commercial Residential
SITE ADDRESS: /`f '`t 1 - Mt LW -
Building Owner
Name: <,c4110,-/.1-21
{/����,,.,../- / �/ Phone: cat". lits-g ) Fax:
Address: /�07 /V,lWfi/ f/ f City: ad #tQ Ved iey State: ti4 Zip:
Contractor
Name: veAealiPhone: Fax:
Address: got 0051,2;0" C,iledfi €,,,,t- a City: State: w 4 Zip: �G� y
License No: ��l City Bus ess Ir-1-1---
yet V &-t q�&CLP✓
Contact
Name: kork"ai,ll e,� Phone: 3Lv�37 p_k_,
DESCRIPTION WORK #OF UNITS X COST = TOTAL AMOUNT
1 FUEL BURNING APPLIANCE Equal to or less than 100,000 1 X $12.00 = (Z-
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) ( X $1.00 = r
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 0-3 TON X $12.00 =
26 AIR CONDITIONER 4-15 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&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
OCASH 0 CHECK 0 VISA 0 MC EXPIRES: PROCESSING FEE $35.00
VIN
CARD#: `f TOTAL PERMIT FEE DUE: 2r`
AUTHORIZED SIGNATURE:
REVISED 8/26/05