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2012, 10-15 Permit App: BLD-2012-1822 Mechanical Fixtures San'c 11707 East Sprague Avenue,Suite 106 509-688-0036-Phone po .ne Spokane Valley,WA 99206 509-688-0037-Fax ,,,Walley For Inspections, call 509-688-0054 Mechanical Permit Application PROJECT 'CT PERMIT ADDRESS: 4q 7 (7 USE: ��67 OWNER /r/,�k c'/ /,7 / PHONE(Daytime Contact): MAILING ADDRESS: / (street) (city/state) (ZIP) CONTRACTOR: )/ z MAILING AD/D �: �� /7 PHONE .LICENSE#: j/ � //A / /-� /C ,--� 676 /6 z �� , ..„..,v,,, � (street) ; city/state) (ZIP) DESCRIPTION OF WORK 6 OF UNITS X COST EQUALS AMOUNT 1 FUEL BURNING APPLIANCE =OR<100,000 X $15 = 2 FUEL BURNING APPLIANCE >100,000 X $19 = 3 UNLISTED APPLIANCE(ADDITIONAL FEE) =OR<400,000 X $50 - 4 UNLISTED APPLIANCE(ADDITIONAL FEE) >400,000 X $100 = 5 USED APPLIANCE(WSEC min.AFUE rating) =or<400,000 X $50 = 6 USED APPLIANCE(WSEC min.AFUE rating) >400,000 X $100 = 7 BOILER/REFRIGERATION 1-100M BTU X $15 = 8 BOILER/REFRIGERATION 101-500M BTU X $28 = 9 BOILER/REFRIGERATION 501-1,000M BTU X $39 = 10 BOILER/REFRIGERATION 1001-1,750M BTU X $57 = 11 BOILER/REFRIGERATION +1750M BTU X $95 = 12 GAS LOG,GAS INSERT,GAS FIREPLACE - X $10 = 13 RANGE - X $10 = /t 7 14 DRYER - X $10 / (� 15 FUEL BURNING WATER HEATER - X $10 = 16 MISC.FUEL BURNING APPL. - X $10 = 17 GAS PIPING(ea.Outlet) - X $1 = / 18 DUCT SYSTEMS - X $10 19 VENTILATING FANS - X $10 = 20 AIR HANDLER(DOES NOT include ducting) =OR<10,000CFM X $12 = 21 AIR HANDLER(DOES NOT include ducting) >10,000 CFM X $19 = 22 EVAPORATIVE COOLERS - X $10 = 23 TYPE I HOOD - X $50 = 24 TYPE II HOOD - X $10 = 25 HEAT PUMP/AIR CONDITIONER 0-3 TON X $12 = 26 AIR CONDITIONER 3-15 TON X $20 = 27 AIR CONDITIONER 15-30 TON X $25 = 28 AIR CONDITIONER 30-50 TON X $35 = 29 AIR CONDITIONER +50 TON X $60 = 30 LPG STORAGE TANK - X $10 = 31 WOOD OR PELLET STOVE/INSERT - X $10 - 32 WOOD STOVE-FREE STANDING - X $25 = SUBTOTAL: / / METHOD OF PAYMENT PLUS PROCESSING FEE: $35.00 MTOTAL PERMIT FEE DUE: /1 (- 0 CASH 0 CHECK 0 0 '.___..-.__ _ r DATE: EXPIRES: j ) tfJ BANKCARD NUMBER: ZI AUTHORIZED SIGNATURE: