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2005, 01-06 Permit App: 05000062 Gas Stovea� MECHANICAL PERMIT APPLICATION Phone: (509) 688-0036; FAX: (509) 688-0037 �J For Inspections, Call (509) 688-0054 Project Address: 7•/ifs 4�2=-C Owner: ->E -z't r3Cc�-e-'z. Mailing Address: le --ti---` ;_, _ Contractor: Mailing Address: License #: Permit Use: Phone (Da Community Development Department Building Division 11707 E. Sprague Avenue, Suite 106 Spokane Valley, WA 99206 lime Contact): gale Lip Gooe Phone #:��'%7_-? bye c tp Looe AUTHORIZED SIGNATURE �� • �(` DESCRIPTION OF WORK # OF UNITS X COST = TOTAA,LL A-M!O,UNT 1 FUEL BURNING APPLIANCE Equal to or less than 100,000 X $1200 = f7 2 FUEL BURNING APPLIANCE More than 100,000 X $15.00 = 3 UNLISTED APPLIANCE Additional Fee Equal to or less than 400,000 X $5000 = 4 UNLISTED APPLIANCE Additional Fee More than 400,000 X $100.00 = 5 USED APPLIANCE SEC min. AFUE rating) Equal to or less than 400,000 X $50.00 = 6 USED APPLIANCE SEC min. AFUE rating) More than 400,000 X $10000 = 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 $2500 = 10 BOILER/REFRIGERATION 1,001 - 1,750M BTU X $35.00 = 11 BOILERIREFRIGERATION More than 1,750M BTU X $6000 12 GAS LOG, GAS INSERT, GAS FIREPLACE X $1000 = F 1 13 RANGE X $1000 = 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 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 1 $10.00 = 23 TYPE I HOOD X $5000 = 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 1 $2000 = 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 STOVEIINSERT 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: ❑ CASH PC11 HECK [:]VISA ❑ MC CARD q' DATE EXPIRES: �l SUBTOTAL PROCESSING FEE TOTAL PERMIT FEE DUE: $3//5..00 I Td .O0 AUTHORIZED SIGNATURE �� • �(`