2007, 09-18 Permit App: 07003692 Water Heater, Piping 4.
Permit Center
Sp01I1C' 11703E Sprague Ave,Suite B-3 PERMIT NUMBER: �C\ 7
`�7 Spokane Valley,WA 99206
's Vaiey. (509)688-0036 FAX:(509)688-0037
Community Development
www.spokanevalley.org PERMIT FEE: f�
Mechanical Permit Application n Commercial RI Residential
SITE ADDRESS: i2-U Q L( E, (2±1a
Building Owner
Name: !.<A r I E BU t-L8G V Phone: 922- bUz e Fax:
Address: !2 y 0 y E, i L City: sr Kinn State: Intl Zip: 61,3 Z(co
Contractor !�
Name: EFF lc l EN C y P l-l.( S Phone: 9,2_6_ 'O O U Fax: 5 3 2 c 0
Address: City: State: Zip:
ly2ll E . R�l�o wcu� S�o!�c�v�e LO �?Z!(0
License No: E F F)G 4 H 9,N I Jr--( City Business Lic:
Contact
Name: Je i'.e 6.0 vv,0,4, Phone: `i 7.....c,_ L)0 00
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 1 X $10.00 = 10. C O
16 MISC.FUEL BURNING APPLIANCE X $10.00 =
17 GAS PIPING(each outlet) 1 X $1.00 = I, 0 0
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 4-15 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 ❑CHECK ❑VISA 0 MC EXPIRES: PROCESSING FEE $35.00
CARD#: VIN: TOTAL PERMIT FEE DUE: N((, 00
AUTHORIZED SIGNATURE:
REVISED 8/26/05