2005, 03-11 Permit App: 05000730 Mechanical Fixtures C ----- '23 0
/'� MECHANICAL PERMIT APPLICATION Community Development Department
sookanoBuilding Division
/ J_ `- Phone: (509) 688-0036; FAX: (509) 688-0037 11707 E. Sprague Avenue, Suite 106
Ydl�'} For Inspections, Call (509) 688-0054 Spokane Valley, WA 99206
Project Adi.( G Q � Permit Use:
d s: SO 1
Owner: '-€C 1�.4 t..tw, -/ �J ,) �i,1 v-k i-L Phone (Daytime Confect):
Mailing Address: S&jM-1
City 'Slate Zip Code
Contractor: kA)41 { ( Ci ( License#: Phone#: )�5-C7'(1, 7
Mailing Address: i2y r City - State Zip Code
DESCRIPTION OF WORK #OF UNITS X OOST = TOTAL AMOUNT
1 FUEL BURNING APPLIANCE Equal to or less than 100,000 1 X $12.00 = (• tl
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 V X $10.00 = 'b-
14 DRYERX $10.00 = • 015 FUEL BURNING WATER HEATER I X $10.00 =
16 MISC.FUEL BURNING APPLIANCE X $10.00
17 GAS PIPING(each outlet) t . X $1.00
15 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 COOLERSX $10.00 =
23 TYPE I HOOD X $50.00 =
24 TYPE II HOODX $10.00 =
25 HEAT PUMP/AIR CONDITIONER 0-3 TON .1 X $12.00 = ' F.
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 TANKX $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 if f)'W
0 CASH 0 CHECK 0 VISA 0 MC DATE: PROCESSING FEE $35.00
CARD#: EXPIRES: TOTAL PERMIT FEE DUE: r on
AUTHORIZED SIGNATURE: