2007, 03-19 Permit App: 07000844 Heat Pump, AC Permit Center
"`kgne 11707E Sprague Ave,Suite 106
Spokane Valley,WA 99206 PERMIT NUMBER: 0 ,5
(509)688-0036 FAX:(509)688-0037 /J
Community Development www.spokanevalley.org PERMIT FEE: 1 // /
Mechanical Permit Application n Commercial ® Residential
SITE ADDRESS: t%313 E. CO4N AV12-• rJ po V`e- \iCc1.1 , WCL CARO1 (o
Building Owner
Name: 3 r1c_,..) `p,,A. 1.�e.pev,..1 Phone: ,6 cs Fax:
Address: 1Q 313 r'1}v` (I:Ve City:SpOkCt+^e_
Val le_3 State:
lA)Ck
Zip: qet0`(v
Contractor
Name: Phone: Fax:
I•C IrnflhCk. (pi 1Vl�S • SOLI- aCict-�(-36"
Address: City: eipe,LA State:
1 ,a1 S• 4b1�elke Dri ve, � W ek Zip: otpl p D LA
License No: (0 L I N E R S 44114 3 S City Business Lie:
Contact
Name: aru x C)p gyp. t Phone: cv:Ict-a(O%Li
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 =
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 $10.00 =
23 TYPE I HOOD X $50.00 =
24 TYPE II HOOD X $10.00 , = ,
25 HEAT PUMP/AIR CONDITIONER 0-3 TON 1 X $12.00 = \a.•0C>
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 l2.•0 0
❑CASH i21CHECK ❑VISA ElMC EXPIRES: PROCESSING FEE $35.00
CARD#: VIN: TOTAL PERMIT FEE DUE: ' V1•00
AUTHORIZED SIGNATURE:
REVISED 8/26/05