2006, 01-04 Permit App: 06000030 Pellet Stove Permit Center
Spokane 11707 E Sprague Ave,Suite 106 PERMIT NUMBER:(�
Valley Spokane Valley,WA 99204 ��/
(509)688-0036 FAX:(509)688-0037 °� *-�1
Community Development www sookanevallev.oro.com PERMIT FEE: / V�
Mechanical Permit Application ElCommercial [residential
SITE ADDRESS: 6</ /a E /31- -----
Building
31- --Building owner e.
Name: i v er (1,-,t 2.j /cI,� Ci,i I ic,J- I Phone: 507-z-2-0(67 Fax:
Address: '/(p 12_ E- (� �7`4./� City: �; D.- State: L,/ Zip: citi 2/Z
Contractor . .
Name: Phone: Fax:
Address: City: State: Zip:
License No: City Business License No:
_ . _.
Name: Phone:
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 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 I X $10.00 = 10
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 I O.O'iO
❑CASH 0 CHECK 0 VISA 0 MC DATE: PROCESSING FEE $35.00
CARD#. EXPIRES: TOTAL PERMIT FEE DUE: 9 ,0.1
AUTHORIZED SIGNATURE: REVISED 8126/05