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2005, 09-14 Permit App: 05003388 Mechanical FixturesPermit Center Spokane 11707 E Sprague Ave, Suite 106 �1r]�M� NUMBER jV11 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037-PERMIi�: Community Development www-.spokanevalley.ora.com Mechanical Permit Application ❑ Commercial (Residential SITE ADDRESS Building owner DESCRIPTION OF WORK Name: ,7 ��,� , i Phone: S % 7j Fax Address: S rCity .9 - State 4c�.�/iL Zip Contractor 1 Name: '`r "r- Phone: , 2 B ' /,2 L/ Fax: Address: / /p/ ;" Ci B State 424f Zi O: / License No: S r I j'f� J'vZ City Business License No: Contact FUEL BURNING APPLIANCE Name: , , ,�,> 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 SEC min. AFUE ratio Equal to or less than 400,000 X $50.00 = 6 USED APPLIANCE SEC min. AFUE ratio 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 1 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 1 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 & 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: ❑CASH ❑ CHECK ❑ VISA ❑ MC DATE: CARD #: EXPIRES: AUTHORIZED SIGNATURE: ,yY �`' SUBTOTAL PROCESSING FEE TOTAL PERMIT FEE DUE: $35.00 E REVISED 8126105