2015, 01-02 Permit App: BLD-2015-0002 Mechanical Fixtures Si �. .14 .",L,.. 1
IZe 11707 E Sprague Ave,Suite 106 ' �+ r�L�1 PERMIT NUMBER:
sey Spokane Valley,WA 990 2Ct +tom"
® (509)658-0036 FAX (509)688-0037
Community Development Wa w.spokanevailev.ora „RECEIVED , PERMIT FEE:
Mechanical Permit Application Commercial ^Residential
sIT'E ADDRESS: 1 _-, ;I ., I��V- JAN 0 2 LU�) lam/ •
Building tiei_��j-5 p< T I - C-SV PERMIT FNTER. . •
Name: P/fu.e../di?Q `Sf + t Phone:Address: `✓ SUB #' iCiy: r?4'
. # 'TTr l State: Zip:
: to- - -
Name. C C7 ill lot t � b'c,A,74�'c A/ Phone: 7 G 8-04.0 7 . . Fax: 9 2 6, ,3/90
Address: /; 0, &x 7$8 C/'t,�47,4„ f te,5 City: 1,r.3/Pt/v Q-' State: fp"?. Zip: l 9(7/6
License 0: C a AV:r(' 6 0 3 6A-6 City Business Lic: G 0 6 2_ 9/h
Contact = ,
Name: ..•. i3,I Alit/
Yr' �.L Phone: Jo t7 v,5d
DESCRIPTION OF WORK #OF UNITS X COST = TOTAL AMOUNT
1 FUEL BURNING APPLIANCE Equal to or less than 100.000 I X $12.00 = i 7
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 101-50DM BTUX $20.00 =
.9 BOILER/REFRIGERATION 501-1,000M BTU X $25.00 =
10 BOILER/REFRIGERATION 1,001-1,75DM 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 = 1(' ' '
16 MISC.FUEL BURNING APPLIANCEX $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 03 TON / X $12.00 = /Z ";
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&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
OCASH 0 CHECK 0 VISA 0 MC EXPIRES: PROCESSING FEE $35.00
CARD#: VIN: TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
REVISED 826/05