2005, 01-19 Permit App: 05000175 Piping 0 - --- / t75--.
/'` MECHANICAL PERMIT APPLICATION Community Development Department
�'�\ Building Division
��t Phone: (509) 688-0036; FAX: ("509) 6$8-0037 11707 E. Sprague Avenue, Suite 106
iU For Inspections, Call (509) 688-0054 Spokane Valley, WA 99206
Project Addre s: /cz/03 fi
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Project Permit Use:
Owner: S' 0 9 0 . / Phone (Daytime Contact):c2/.- ,/p/ 3
Mailing Address: �fo�f City State Zip Code
Contractor: 61 V/Eie License#: /,� ..s '+%8Phone#: (25:5--9'9Y,5"'-.2/7-02,/3
Mailing Address: /IO /�lp c� y =r- A44 e/ 9
ti �CState Z�Code
DESCRIPTION OF WORK #OF UNITS X COSTTOTAL 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 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 DRYERX $10.00 =
15 FUEL BURNING WATER HEATER X $10.00 =
16 MISC. FUEL BURNING APPLIANCE
� _/ !Y, �� _ X $10.00 =
17 GAS PIPING(each outlet�X0" //r/C�pc cA �f-c7C./i47.' 2 X $1.00 = R. 06
18 DUCT SYSTEMS 10 S 197J �r7) - 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 HOODX $50 00 =
24 TYPE II HOODX $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 = J
-
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 , -CII)
0 CASH red-HECK HECK ❑VI . 0 MC DATE j(%/�� PROCESSING FEE - $35.00
CARD# _ / /�n EXPIRES:' TOTAL PERMIT FEE DUE: �7 /, o�
AUTHORIZED SIGNATUR. 7i�P,"' i . G>r/�'✓