2005, 04-07 Permit App: 05001102 Mechanical Fixtures ll. ,
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MECHANICAL PERMIT APPLICATION Community Development Departmen
ern Building Divisiol
II Phone: (509) 688-0036; FAX: (509) 688-0037 11707 E. Sprague Avenue, Suite 101
�1 For Inspections, Call (509) 688-0054 Spokane Valley, WA 99201
Project Address: /I �? Permit Use: £I �[c',✓�1
Owner: RA y �,f . , Phone (Daytime Confect):
Mailing Address: --Wyk/���r�-� Zip Code
Contractor: hml�9`- • /�t c' o wl.?/ License#: 4-/7�i 3 Phone#: -k `-
Mailing Address:
City State Zip Code
DESCRIPTION OF WORK • #OF UNITS X COST = TOTAL AMOUNT
i 1 FUEL BURNING APPLIANCE Equal to or less than 100,000 X $t2.00 , =
t
• 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 •
= -
B 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 520.00 = •
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 1 X $10.00 =
14 DRYER X $10.00 =
15 FUEL BURNING WATER HEATER ) X $10.00 =
16 MISC.FUEL BURNING APPLIANCE • 8 (3 R • l 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 111-1000 ' $10.00, =
25 HEAT PUMP/AIR CONDITIONER • 0-3 TON X $12.00 • =
i 26 .AIR CONDITIONER 3-15 TON X $20.00 . ._
27 AIR CONDITIONER . 15-30 TON X $25.00 =
. • 28 AIR CONDITIONER30-50 TON X $35.00 =
29 AIR CONDITIONER • More than 50 TONX $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 d,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
• 0 CASH 0 CHECK 0 VISA D MC DATE PROCESSING FEE $35.00
CARD#: EXPIRES: TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE: