2007, 11-02 Permit App: 07004406 Mechanical Fixtures • 1.
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Wiliam 11703 E Sprague Ave,Suite B-3
P Spokane Valley,WA 99206 PERMIT NLTMBER:OU
jValler (509)688-0036 FAX:(509)688-0037 PERMIT FEE:
Community Development a'wwspokanevallev.or_
Mechanical Permit Application ' 4.-e _.
El Commercial Residential
SITE ADDRESS: / g,,� (I LJ 1-_ �-2 `
Building Owner
Name: D(.7fir,e We f 4 Phone: q Z 6.54 34 Fax:
Address: -r+}f City: State: V�� Zip: q?a
3 514-- E. 6 Ave, ,SPA 461.vte, VaD d r l 4.
Contractor
Name: Phone: Z.2 0-6 3 6 3 Fax:
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Address: I Z `�c 5b vi City: S1�o1�a y‘...
` Q State: WA Zip: l 3
License No: sp.)g - I it Z\\)d c s City Business Lic:
Contact Ja.s,, ,t acw.- N
Name: Phone: ZZO 6363
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DESCRIPTION OF WORK #OF UNITS X COST = TOTAL AMOUNT
1 PPJEL BURNING APPLIANCE Equal to or less than 100,000 I 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 DRYER _ X $10.00 =
15,,A jUEL BURNING WATER HEATER I X $10.00 =
16 MISC.FUEL BURNING APPLIANCE X $10.00 =
17'•' AS PIPING(each outlet) 2 X $1.00 =
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
❑CASH 0 CHECK 0 VISA 0 MC EXPIRES: PROCESSING FEE $35.00
CARD#: VIN: TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
REVISED 8/26/05