2008, 12-31 Permit App: 08004866 Stove Permit Center
S � dlle ri11703 E Sprague Ave,Suite B-3 c .../�4
p Spokane Valley,WA 99206 / PERMIT NUMBER:
.Valley" (509)688-0036 FAX:(509)688-0037 c.,\C) PERMIT FEE:
Community Development permitcenter@spokanevalley.org
Mechanical Permit Application I I Commercial I I Residential
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SITE ADDRESS: ' k r'> GE \''Crk
Building Owner
Name:/ S� (��� Phone: 6-09 'Z� 3' 5- 0 Fax:
(�1 Gl T ff
Address: 0 IA E- l Ci y: 5:�-I�Ccv.i 1 t Gs� State: ln10 Zip:(lei.7c)(c.,
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Contractor 1
Name: (_,,,/,c,.,- Phone: Fax:
Address: 3 3 City: State: Zip:
License No: City Business Lic:
Contact
Name: ✓1 i i 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 4-15 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 X $10.00 =
31 WOOD OR PELLET STOVE/INSERT ` X $10.00 = I O oG
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 U tic'
['CASH 0 CHECK 0 VISA 0 MC EXPIRES. PROCESSING FEE $35.00
CARD#: VIN' TOTAL PERMIT FEE DUE: LlS.
AUTHORIZED SIGNATURE:
REVISED 8/26/05