2006, 10-03 Permit App: 06003964 Insert, Piping r nr L eager
S p Ede 11707 E Sprague Ave,Suite 106 PERMIT IrUA/BER
- fey Spokane Valley,WA 99205 ��v j�'/
(509)65g-0036 FAX:(509)5S8-0037 J.--h
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Community Development u�w.sookanevallev.or2 PERMIT FEE: `E�
Mechanical Permit Application ❑ Commercial N Residential
SITE ADDRESS: Al:0U E. \:s1t�b k��' _ � \\) A 09 Z ( 2-
Building Owner
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Name ��-�wi vs,`C, %\r_cl P� Phone: )�-{U $-I 1ZFax: q qs �� 1_4Address: A! Ol.� ( �t _ Ci r State:
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Contractq __�.�.�� -��
Name: 1 t V, Phone: Fax:
Address:✓ City: State: Zip:
License No: City Business Lic:
Name "')Y, ( PhoneH .. .
DESCRIPTION OF UNITS X COST = TOTAL AMOUNT
1 FUEL BURNINGOF APPLIANCEWORK 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 - 1-10DM 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 =
yk 17 GAS PIPING(each outlet) I X $1.00 =
li 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 =
26 AIR CONDITIONER 30-50 TON X $35.00 =
29 AIR CONDITIONER More than 50 TON X $60.00 =
3D 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 0 CHECK ElVISA 0 NIC EXPIRES: PROCESSING FEE $35.00
CARD#: VIN' TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
REVISED B26/05