2008, 06-19 Permit App: 08002340 Piping Permit Center
*Mane 11707E Sprague Ave,Suite 106 P �• j � �L j/)
s �j Spokane Valley,WA 99206 1
® , (509)688-0036 FAX:(509)688-0037 PERMIT FEE: `1
Community Development www.saokanevaliev.orm
Mechanical Permit Application ❑Commercial [ l‘sidential
SITE ADDRESS: 1 1411 2, r - -o
Building Owner /)t ( ^ c e
Name: / Phone: e' ZCYSi' Fax: i p
Address: 1 c `�b Z Z i. . 2 074` Ci� (CAP U^jai State: ' if ZP= C o�
contractor J
Name: Phone (n 7. 6pis; Fax She',;� ;
Address: / yitI Z I- C.a- (lam City: et (fetes state: LA/4- Zip l` ieh
License No: go_HEA/4-ivez-0City Business Lic:
ContacE' i
Name: Phone -7 i U -L -V( Cell
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 mm .AFUE ring) 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 TION 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 HANDLED?(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 CONDONER 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&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
['CASH 0 CHECK 0 VISA OMC EXPIRES: PROCESSING FEE $35.00
Ai
CARD#: TOTAL PERMIT FEE DUE: 37- CJ O
AUTHORIZED SIGNATURE: .
REVISED 8n5105 k
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