2004, 10-22 Permit App: BLD-04-08012 Mechanical Fixtures i
J
MECHANICAL PERMIT APPLICATION
SliaaneCity of Spokane Valley Community Development Department
�j��pp BuildingDivision
1 'ti 114
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
. Phone: (509)688-0036;Fax: (509) 688-0037
FOR INSPECT ONS,.`CALL(509) 688-0054
Project Addr s: / /0 /9 f�
Permit Use: G6f/ hi -6,,,,,,,,,,
Owner.. M 4 / Phone(Daytime Contact):
Mailing Address: /5 2/ 0 E re'`G 1/., A! 7' G<,L 9r�s 7
City . ' State , lip Code
Contractor: /)CC42i"-figs License#: Phone#: Y 3�?..,_
Mailing Address: 5-f-atlF' •
City . State Zip Code
#OF TOTAL
DESCRIPTION OF WORK UNITS ' X COST - AMOUNT
1 1 FUEL BURNING APPLIANCE Equal to or less than 100,000 1 X $15.00 = , / 5-4..)°
_ 2 -Ft3Et-Bt RNING-APPLIANuE Maneltaf 100,000 X $18.00 =
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 =
USED APPLIANCE(WSEC mina AFUE
6 ratIV Equal to oftess than 40(4000 • ,X $50.00 =
• USE)APPLIANCE(WSEC min.AFUE
6 rating} More than 400,000 X $100.00 =
7 BOtLER/REFRIGERATION 1-100M BTU • • X $15.00
E ISMER/REFRIGERATION 101-500M BTU $28.00 =-
9 BOILER/REFRIGERATION 501-1,000M BTU $39.00 =
10 BOILER/REFRIGERATION 1,001-1,750M BTIJ $57.00
•
It BOU.ERfREFRIGERATION More than 1,750M BTU $95.00 -
12 GAS LOG,GAS INSERT,GAS FIREPLACE • $10.00 =
13 RANGE $10.00 =
14 DRYER $10.00 = ,
15 FUEL BURNING WATER HEATER $10.00 = '
16 MISC.FUEL BURNING APPLIANCE $10.00
17 GAS PIPING(each outlet) $1.00 =
1$ DUCT SYSTEMS $10.00 =
19 VENTILATING FANS• $10.00
Y
20 AIR HANDLER(DOES NOT Include ducting) Equal to or less than 10,000 CFM $12.00 =
21 AIR HANDLER(DOES NOT include ducting) Greater than 10,000 CFM $19.00 = I
22 EVAPORATIVE COOLERS $10.00 =
23 TYPE I HOOD • $50.00 =
24 TYPE It HOOD $40.00 . _
25 HEAT PUMPIAIR CONDITIONER • • . • $3 TON $12.00 =
26 AIR CONDITIONER 3-15 TON $20.00 =
_ _27--'-/MR-0014DITIDN€R- • - 13-3oTON -- 25.00 =
28 AIR CONDITIONER 30-80 TON $35.00
20 ' AIR CONDITIONER More than 50 TON $60.00 = •
30 : LPG STORAGE TANK . • $10.00 =
a1 WOOD OR PELLET STOVE/INSERT X $10.00 . =_
32 { WOODSTOVE-FREE STANDING. X $25.00 . =_ _{�
METHOD OF PAYMENT: SUBTOTAL ' (S`"()0
Q CASH OCHECK Q VISA ()MC DATE: • PROCESSING FEE ]$335..0o
CARD#: .
EXPIRES: TOTAL PERMIT FEE DUE: . ✓.CO
,)'6V
AUTHORIZED SIGNATURE: i '