2005, 02-23 Permit App: 05000555 Mechanical Fixturesane
Project Addss.
Owner brVCR- v ne.11
Mailing Address: n-tq•
tret
MECHANICAL PERMIT APPLICATION
Phone: (509) 688-0036; FAX: (509) 688-0037
For Inspections, Call (509) 688-0054
,70g/ N woos Kv-P-1-
Contractor:
Mailing Address.
Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Permit Use:
Phone (Daytime Contact):
License #:
City
State
Phone #:
Zip Code
State
Caere
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
# OF UNITS
X
C -OST
=
TOTAL AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
�J
p4-
X
Si2.D90
=
at
&V .
2
FUEL BURNING APPLIANCE
More than 100,000
X
515.00
=
3
UNLISTED APPLIANCEFee) •
Equal to or less than 400,000
X
55000
=
4
.(Additional
UNLISTED APPLIANCE (Additional Fee)
More than 400,000
X
5100.00
=
'
5
USED APPLIANCE (WSEC min. AFUE rating)
Equal to or less than 400 000
X
550.00
=
6
USED APPLIANCE (WSEC min. AFUE rating)
More than 400,000
X
5100.00
=
7
BOILER/REFRIGERATION
1: 100M BTU
X
512.00
=
8
BOILER/REFRIGERATION
101 .500M BTU
X
520.00
=
9
BOILER/REFRIGERATION
501 - 1,000M BTU
X
525.00
=
10
BOILER/REFRIGERATION
1,001 •1,750M BTU
X
535.00
=
11
BOILER/REFRIGERATION
More Than 1,750M BTU
X
560.00
=
12
GAS LOG, GAS INSERT, GAS FIREPLACE
X
• 510.00
=
13
RANGE
.X
510.00
=
14
DRYER
X
510.00
=
15
FUEL BURNING WATER HEATER
X
510.00
=
16
MISC. FUEL BURNING APPLIANCE
X
510.00
=
17
GAS PIPING (each outlet)
42
X
51,00
=
a-
18
DUCT SYSTEMS
X
510.00
=
19
VENTILATING FANS
X
510.00
=
20
AIR HANDLER (DOES NOT include ducting)
Equal to or less than 10,000 CFM .
X
512.00
=
.
21
AIR HANDLER (DOES NOT Include ducting)
Greater than 10 000 CFM
X
515.00
=
22
EVAPORATIVE COOLERS
X
510.00
=
23
TYPE I HOOD
X
550.00
=
24
TYPE 111-1001)
X
510.00
=
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
X
512.00
=
26
.AIR CONDITIONER
3-15 TON
X
520.00 •
.=
27
AIR CONDITIONER
15-30 TON
X$25.00
=
28
AIR CONDITIONER
30-50 TON
X
535.00
=
29
AIR CONDITIONER
More than 50 TON
X
560.00
=
30
LPG STORAGE TANK
X
510.00
=
31
WOOD OR PELLET STOVE/INSERT
X
510.00
=
32
WOOD STOVE - FREE STANDING
X
525.00
=
33
REPAIR & ADDITIONS•
X
$15.00
=
34
VENTILATION SYSTEMS
-
X
' 512.00
=
35
VENTILATION MECHANICAL EXHAUST
X
512.00
=
36
INCINERATOR -RESIDENCE t
X
519.00
=
37
INCINERATOR - COMMERCIAL
X
522.00
-
METHOD OF PAYMENT:
0 CASH ,CHECK 0 VISA 0 MC
CARD #:
DATE:
SUBTOTAL
�.
04 COc'-
PROCESSING FEE
535.00
EXPIRES:
TOTAL PERMIT FEE DUE:
l,�_
AUTHORIZED SIGNATURE: