2007, 04-05 Permit App: 07001140 Mechanical Fixtures Permit Center
�" [le 11707E Sprague Ave,Suite 106 ‘
---7-
.000 Valley Spokane Valley,WA 99 PERMIT NUMBER: 1 l
(509)688-0036 FAX:(5 2607
Community Development ;;VV.spnkapcc allcv ora � PERMIT FEE: s---g -------
Mechanical Permit Application ❑Commercial Residential
SITE ADDRESS: /'970/ L i 6 ` `
Building Owner
Name: �/fPir , O')" L r��Yl Phone:st p,... �Oe.C1`:.90 4 Fax:
Address:(' , /4/709 F /Zp c7 7 City' \ Valles/ State: A Zip:C�//Qc37
Contractor��//'Rcxi, creek, i'yC+ . 73{�
Name: PtWtem - Phone:JL.- '924,-2?Wax: 9.- 926-295---
Address: I7ZD y F S/vr'a.c.9Gk0 City' J 0.Uttt vcd`e,/ State:
IA)a Zip:CI liC) N
License No:Q oc{,[ -('q 50 KC City Business Lic: Coo Z 3o1- Ti y/
Contact ` � y
Name: A wic _._t,. Phone: l 0,-92 2 wc,
DESCRIPTION OF WORK #OF UNITS vv X COST = TOTAL AMOUNT
1 FUEL BURNING APPLIANCE Equal to or less than 100,000 / X $12.00 = /2
2 FUEL BURNING APPLIANCE More than 100,000 X $15.00 =
3 UNLISTED APPLIANCE(Adcional 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 = /6 -
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 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
30 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&ADDETIONS 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
OCASH 0 CHECK VISA 0 MC EXPIRES: PROCESSING FEE �/$35.00
CARD#: VIN: TOTAL PERMIT FEE DUE: KD IT.eli
AUTHORIZED SIGNATUREC'
REVISED 8/26/05