2006, 09-20 Permit App: 06003779 Piping JI1V21111_ C •••"• ••••r•�e--... YLAlYLL1 IN VD IVLI- .� // )
��SS\•ja�at)'Ta`.n'.T, Spokane Valley,WA 99206
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Mechanical Permit Application ❑ Commercial ❑ Residential
SITE ADDRESS// ,CC3 ? l- a
Building 0waer,Dov, ci F,rY r-r7-
Name: q�y m Phone J 3)p�._S sIC Fax:
Address: 4�Sc,sn e City.,Spo//0 n-P Mary jc`, ap: 792/ `2
Name: Phone: Fax:
Address: City- State: Zip:
License No: City Business Lic:
Comma r. ',:.
Nam= Phone
DESCRIPTION OF WORK at OF UNITS_ X COST = TOTAL AMOUNT
1 FIA BURNING APPLIANCE Equal b or less than 100,000 l 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(Addition Fee) More than 400,000 X $100.00 =
5 USED APPLIANCE MSEC min.AFUE ralinq) Equal to Dr less than 400,000 X $50.00 =
6 USED APPLIANCE MSEC min.AFUE rating) More than 400,000 X $100.00 =
7 BO8_ERREFRIGERATIDN 1-100M BTU X $1200 =
B BOILER/REFRIGERATION 101-500M BTU X $20.00 =
9 BOLER/REFPJGERATION 501-1.000M BTU X $25.00 =
10 BORERREFRIGERATION 1.001-1,750M BTU X $35.00 =
it BCLERREFRIGERATIDN More than 1,75DM BTU X $60.00 = ,
12 GAS LOG.GAS INSERT,GAS FIREPLACE X $10.00 =
13 RANGE X 510.00 =
14 DRYER X $10.00 =
15 FUEL BURNING WATER HEATER X $10.00 =
18 MISC.FUEL BURNING APPLIANCE X $1000 =
17 GAS PIPING Leacl1 outlet) _ / t X $1.00 =
iB DUCT SYSTEMS X $10.00 =
19 VENTILATING FANS _ X $10.00 •
20 AIR HANDLER(DOES NOT include ducting) _ Equal In or less Man 10,000 CFM X $12.00
21 AIR HANDLER(DOES NOT include ducting) Greater Man 10,000 CFM X $15.00
22 EVAPORATIVE COOLERS X $10.00 =
23 TYPE I HADD X $50.00 =
24 TYPE II HOOD X $10.00 =
25 HEAT PUMP/AIRCONDRIONER 0-3 TON X $12.00 =
26 AIRCONDDIONER 3-15 TON X $20.00 =
27 MR CONDITIONER 15-30 TON X $25.00 =
2B AIR CDNDITIONER 30-50 TON X _ $35.00 =
29 AIR CONDRIONER 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-FREESTANDING X $25.0D =
33 REPAIR 8 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
I:CASH ❑CHECK 0 VGA ❑MC EXPIRES: PROCESSING FEE S35.0D
CARD P VIN' TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
REVISED arz6m5