2008, 03-04 Permit App: 08000681 Water Heater r .
�\ Permit Center t&' /„ S I
g*1� '�����r 11703E Sprague Ave,Suite B-3 PERMIT NUMBER: 60
�Y Spokane Valley,WA 99206
(509)688-0036 FAX:(509)688-0037 PERMIT FEE: if
Community Development
www.spokanevalley.org J
Mechanical Permit Application IDCommercial lig Residential
SITE ADDRESS: &co [/ (l 'F- �1 7pt /
Building Owner 0.47,41
- .27i,„.. .0..-04e4,„
Name: ,v,�Co/ Phone: 3 y-Q 7 "'A Fax:
Address: 6 C-0D t( / .7 � City: ,Bke,,,e. - .II,., State: W - Zip: 9.? /7i
Contractor + .!! r-7 ` q s�
Name: .e !?7 - Phon .� _�®CO��Fax: g> l Cts�r 1
2.3
Address: IJV ( i'a/�'� DR City:f •i)14- State: ��/ Zip:ewer
License No: 1/ SGS 9,( / City Business Lic:
Contact j` 4",I� /�/ / t
Name: �rtit !m �'° �!J Phone m a"q) L,!a 5f-(J k( ,g Z 9',8
DESCRIPTION OF WORK _ #OF UNITS X COST = TOTAL 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 DRYER X $10.00 =
15 FUEL BURNING WATER HEATER X $10.00 = lf.DQ
16 MISC.FUEL BURNING APPLIANCE X $10.00 =
17 GAS PIPING(each outlet) X $1.00 =
18 DUCT SYSTEMSX $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 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/INSERTX $10.00 =
32 WOOD STOVE-FREE STANDINGX $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 X $19.00$ 9.00
37 INCINERATOR-COMMERCIAL r o (�
METHOD OF PAYMENT: SUBTOTAL
EXPIRES:
❑CASH 0 CHECK FVISA ❑MC PROCESSING FEE $35.00
VIN: `
TOTAL PERMIT FEE DUE: 7 c�O6)
CARD#:
AUTHORIZED SIGNATURE:
P:\Community Development\Farme\Building forms\Mechanical Permit Applicetiondoc
Effective 10-28-07