2005, 11-01 Permit App: 05004110 Mechanical Fixtures Permit Center
Spokane 11707 E Sprague Ave,Suite 106
PERMIT NUMBER:
.,Valley Spokane Valley,WA 99206 _ . O
(509)688-0036 FAX:(509)688-0037 PERMIT FEE:
Community Development www.spokanevalley.ore.com
Mechanical Permit Application El Commercial Residential
SITE ADDRESS: /35;/ 7/H iil;/,
Building owner !i (rf)a3
Name: 4 41-,yam /%-_ Phone: ,l Fax: Q'Q
Address: 3/11- j & ,2 �-- /►()-' --
Name:
^ City: jf/1t)t17e j/ / te: � Zip: / /�!
Contractor we Re. 0 ) _ /I�/ r`J"/ t� 271f75-
' r �7
Name: /�)-? �r 4r SLS r/ Phone: 5-3N a Y f7, Fax: Tj'/ /5-7 2
Address: 57,0 7 , rte"if r` City: 5 ,4)f 1?e State: SAL Zip:if✓e/„7
License No: City Business License No:
Contact I f
`-/
Name: �//4> f e,"41 jt7 P 4 t`'`/ Phone: 7 "4/f
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 I $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 =
16 MISC.FUEL BURNING APPLIANCE X $10.00 =
17 GAS PIPING(each outlet) 02 X $1.00 =
1
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 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 =
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 ,
DCASH rg CHECK O VISA D MC DATE: PROCESSING FEE $35.00
CARD#: EXPIRES: TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE: REVISED 8/26/05