2006, 08-25 Permit App: 06003389 Insert ouzo' -\,,.... rerm:t tenter
S�kerne 11707 E Sprague Ave,Suite 106
Valley Spokane Valley,WA 99206 PERMIT NUMBER: 33C'
I.
(509)658-0036 FAX:(509)685-003/ PERMIT FEE: -
Community Development WWW.st>okanevallev.ora 4/ SJ
Mechanical Permit Application ❑ Commercial ❑ Residential
SITE ADDRESS: t(D 7 0 3 L^. ) L/ 14- .
Building Owner /'i`j/<L AA.iti
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Name:
_ /1-0, Phone: Cj)6 . ?6f_3 6I3 Fax:
Address: (e .7 6 3 6.--- )q 774 City. c7� ►`i--Nf )i -L(- -f5
tate: J61 . zip: q I Z-) -
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Contractor•
Name: Phone: Fax
Address: City: State: Zip:
License No: City Business Lie:
Conrad -- _ ,
Name: Phone:
DESCRIPTION OF WORK 8 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 =
B BOILER/REFRIGERATION 101-50DM 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 =
16 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 =
3D LPG STORAGE TANK X $10.00 =
31 WOOD OR PELLET STOVFJINSERT 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
MASH ❑CHECK ❑VISA ❑MC EXPIRES: PROCESSING FEE $35.00
CARD#: VIN: TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
REV1SED 626/DS