2005, 10-17 Permit App: 05003855 Mechanical Fixtures 0r�,,� Permit Center
*Wane11707 E Sprague Ave,Suite 106
x }0 11@PERMIT NUMBER: " ICCY
`� Spokane Valley,WA 99206 .J.L)J
VAll� (509)688-0036 FAX:(509)688-0037 , • - t )
Community Development www.sookanevalley.ore.com PERMIT FEE: G-
Mechanical Permit Application �/ n Commercial ]Residential
SITE ADDRESS: G 4' 2/3 r ,y 11/1
e
Building owner s7)/..2,411l //, lire C1//
Name: Phone: Fax:
Address: City: State: Zip:
Contractor
Name: dea4/4't4 0,1a4ek4, �� Phone: 6--1 ,9:-C37677 Fax: �y
Address: i i � Ane e)r C // City: -IA j State: Wief Zip:VL
/
License No: i9 p/}1j,v///5 f/y Q4 City Business License No:
Contact
Name: LbA 'T�//,ji/ Phone: 369, 954'
-
DESCRIPTION OF WORK #OF UNITS X COST = TOTAL AMOUNT
1 FUEL BURNING APPLIANCE Equal to or less than 100,000 r 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 3 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 6hedge_ 1 / / X $10.00 =
17 GAS PIPING(each outlet) e X474 f $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 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
❑CASH 0 CHECK ❑VISA ElMC DATE: PROCESSING FEE $35.00
CARD#: EXPIRES: TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE: ,% it REVISED 8/26/05
6