2008, 11-06 Permit App: 08004405 Mechanical Fixtures Sa �re( 11707 East Sprague Avenue,Suite 106 509-688-0036-Phone
pOi e Spokane Valley,WA 99206 509-688-0037-Fax
00Val leY For Inspections, call 509-688-0054
Mechanical Permit Application y __--
PROJECT PERMIT
ADDRESS: 15)3,0 L aN N USE:
OWNER i5 P . JC-C( iu cJ C•12_ PHONE(Daytime Contact): l_67 c?_, c vs—
MAILING ADDRESS: 7
L 5-PC) _ �w 5D °.-/ u,A %/)/Z
(street) (city/state) (ZIP)
CONTRACTOR: CI( 2._ LICENSE#: p i 2,, f
MAILING ADDRESS: PHONE It: ! `/S)-733
5 51 M A tl v 1) `4.)L444.5 t J t.)-/
(street) (city/state) (ZIP)
DESCRIPTION OF WORK #OF UNITS X COST EQUALS AMOUNT
1 FUEL BURNING APPLIANCE -OR<100,000 I X $15 /5
2 FUEL BURNING APPLIANCE >100,000 X $19 -
3 UNLISTED APPLIANCE(ADDITIONAL FEE) =OR<400,000 X $50 =
4 UNLISTED APPLIANCE(ADDITIONAL FEE) >400,000 X $100 =
5 USED APPLIANCE(WSEC min.AFUE rating) -or<400,000 X $50 =
6 USED APPLIANCE(WSEC min.AFUE rating) >400,000 X $100 =
7 BOILER/REFRIGERATION 1-100M BTU X $15 =
8 BOILER/REFRIGERATION 101-500M BTU X $28 =
9 BOILER/REFRIGERATION 501-1,000M BTU X $39 -
10 BOILER/REFRIGERATION 1001-1,750M BTU X . $57 =
11 BOILER/REFRIGERATION +1750M BTU X $95 -
12 GAS LOG,GAS INSERT,GAS FIREPLACE - X $10 -
13 RANGE - X $10 -
14 DRYER - X $10 -
15 FUEL BURNING WATER HEATER - X $10 -
16 MISC.FUEL BURNING ADPL. - X $10
17 GAS PIPING(ea.Outlet) - 4 x si '
18 DUCE SYSTEMS - I X $10 - /0
19 VENTILATING FANS - X $10 =
20 AIR HANDLER(DOES NOT include ducting) =OR<10,000CFM X $12 =
21 AIR HANDLER(DOES NOT include ducting) >10,000 CFM X $19 -
22 EVAPORATIVE COOLERS - X $10 -
23 TYPE I HOOD - X $50 -
24 TYPE II HOOD - X $10 =
25 HEAT PUMP/AIR CONDITIONER 0-3 TON r X $12 j 2-
26 AIR CONDITIONER 3-15 TON X $20 -
27 AIR CONDITIONER 15-30 TON X $25 =
28 AIR CONDITIONER 30-50 TON X $35 =
29 AIR CONDITIONER +50 TON X $60
30 LPG STORAGE TANK - X $10
31 WOOD OR PELLET STOVE/INSERT - X $10 -
32 WOOD STOVE-FREE STANDING - X $25 =
SUBTOTAL: 3 .0-
METHOD OF PAYMENT PLUS PROCESSING FEE: $35.00
MOM TOTALPERMIT FEE DUE: .C9
VISA • ii~ t ��
❑ CASH ❑ CHECK ❑ ❑ --- =".._
DATE: EXPIRES:
BANKCARD NUMBER
AUTHORIZED SIGNATURE: