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2007, 08-20 Permit App: 07003251 Gas FixturePermit Center Spb'kane 11703 E Sprague Avq Suite 13-3 - -- 14 Spokane Valley, UrA 99206 PERMIT NUMBER: � V A1W (509)688-0036 FAX (509)688.0037 Community Development tvn^v.snokanevallev ore PER.l1IT FEE: iblechanical Permit Application ❑ Commercial [+ Residential SITE ADDRESS: .a. -..r:...0Y+..A.. '•3 �':i: 7 S'..w::�1::i�-.'ti`..r!..:�,n�i..'.1t!?a Name:, Js:1.4�y.� ��.Q3'�. f S w t 1 i r'i'.�57 •:.�' .a..•a yY' 1 %. f. tC it.. Tim t 7G S. �'' `. .. Phone _ Fax: Address 7 State: `� Zip• .. vnC,t, 1. FZ.i '+4 e.tL,. �, 1....w,t. �•.f..-4faV\�1. f•'� fi•.',: f. ...C,, ..t+�•?.'. ... Name: . LC 'f xrFlih))� .n. ^�..• S.,.Yrnh� i, Phone:' S 'a h�•.ialt:.!..)]�',{A3[w K%Yti,- W.t. taJ��€ 2 .,.. tSf.f.k, v �i •S 3-1-1,0105 �f �k1 x%yit:. . lK-1, �6 C Address: s 0 S- /S -.o Fax: Sag 305-a7Coj5 l/�� Sd Llcrnsc CI City d eaI,,� tate: ZIP• 9a�} No J`5%-Ue67 Q Q CctyBusmess Ltc /0 �On�att+ >F..t1.': St i:'at{ <a ySt .141 �''� .Y") r `X! Fi�'•io.4 .} t :.+. f 1 t. �) } c• ! ! 2. w r� X n..S.C... > 1{_. •..:4 .M• :. v�Ri!">. �{.: i..•. S :.rf+�.� Jr ..3'�„�.'t. tj{ f`.,,.{. 1 �� ! i ). �� 4 ;,3 1 t �:.�1 �;.�.s>tl.`.Tt �•..?I Name: .. ..Y•...n... ., i. t t..:I�4 ' � �;.�' .Y., .;4 , ..SL!`1�. �.. � .4 o i it Phone. DESCRIPTION OF WORK 1 FUEL BURNING APPLIANCE E uat to less # OF UNITS XCOST TOTAL AMOUNT cr than 100000 2 FUEL BURNING APPLIANCE More than 100000- 3 UNLISTED APPLIANCE Additional Fee E ual to or less than 400,000 X $50.00 4 UNLISTEDAPPLIANCE Additional Fool More than 400,000 5 USED APPLIANCE SEC min. AFUE ratin III Equal to or len than X SIODA0 - 400000 X 550.00 - 6 USED APPLIANCE SEC min, AFUE ratin) More than 400,000 X $100.00 - 7 BOILERIREFRIGERATION 1 - t00M 9TU X - 6 BOILERIREFRIGERATION 101 - SOW BTU _$12.00 X $20.00 9 ©OILEWREFRIGERATI- 501 1,00011A - BTU X $25.00 - 10 EOILERGSEFRIGERATION 1.001 -1.750!.! BTU X 1135.00 11 BOILERrREFRIGERATION More than 1,750M BTU X efi0.00 - 12 GAS LOG, GAS INSERT, GitS FIRE?LACE 113 RANGE X 570.00 - = 14 DRYER x $70.00 _ X - F10.00 15 FUEL BURNING WATER HEATER 510.Co 16 MISC. FUEL BURNING APPLIANCE X $10.(10 - 17 GAS PIPING each outlet X $1.00 - 18 DUCT SYSTEMS X $10.00X 19 VENTILATING FANS S10.00 = 20 AIR HANDLER DOES NOT includo ductin E ual to or loss then 10,000 CFM X $12.00 - 21 AIR HANDLER DOES NOT include ducting Granter than 10,000 CFM 22 EVAPORATIVE COOLERS X ,15.00 - 23 1 TYPE IHOOD X 510.00 - X $50.00 - 24 TYPE ItHOOD X $10.00 = 25 NEAT PU!l.PlAIRCONDITIONER 0.3 70N 0.3TON 26 AIR CO\01TIONER X F i200 X 20.00 - 27 AIR CONDITIONER 18.30 TON X $25.00 - 28 AIR CONDITIONER 30.50 TON X $35.00 - 29 AIR CONDITIONER More then 50 TON X LP 30 G STORAGE TANK 56C.00 - X $10.00 - 31 WOOD OR PELLETSTOVEII,VSERT X - $1010 32 WOODSTOVE- FREESTANDING 33 REPAIR 8 ADDITIONS ..00 X - 00 - 34 VENTILATION SYSTEMS $16.00 XX 35 VENTILATIONMECHANICAL EXHAUST 512,00 36 INCINERATOR - RESIDENCE .00 X $12 - 37 INCINERATOR -C061MERCIAL X $12.00 X 1 $22.00 c METHOD OF PAYMENT: c• SUBTOTAL -� - PROCESSING FEE _ 535.00 AUTHUFtt2L SIGNATUP.F: ��� ... .Ps. TOTAL PERMIT FEE DUE: - - •- '" REVISED WC,"01 - This document origi nally tained confidential credit card info mat on which was redacted pursuant to RCW 19.25.010 and the original document destroyed Pursuant to SOS DAN G52034 030, AUG 20 2007 10:09 5093252615 PAGE.01