2008, 11-15 Permit App: 08004759 Wood Stovejerky
CITY OF SPOKANE VALLEY
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
aermitcenter0spokanevalley.or4
(Staff Use Only)
PERMIT NUMBER: `h
PERMIT FEE:
MECHANICAL PERMIT APPLICATION
❑ COMMERCIAL E71 -'RESIDENTIAL r I j /�
SITE ADDRESS: J )— F— � 5-� 5 �r et �nOl��r JCC i� l l2X (,lJ�-h'
BUILDING OWNER NAME:
CITY: f:6)al kAfl (J-Uj'R., UOM STATE: LA" ' ZIP: Vff"4V .Y %
PHONE:�n FAX: CELL:
CONTACT NAME: +� �� jL)0—' t
PHONE: , �? FAX: CELL:
CONTRACTOR NAME:
MAILING ADDRESS:
CITY: STATE: ZIP:
PHONE: FAX: CELL:
CONTRACTOR LICENSE NO.: EXPIRES: CITY BUSINESS LICENSE NO.:
MANUFACTURER:
PREVIOUS ADDRESS:
PROPOSED USE:
Effective October 28, 2007 Page 1 of 2
http://www.spokanevalley.org/uploads/Community_Development/Documents/Forms/Building/Mechancial Permit App.l.doc
SUBTOTAL
PROCESSING FEE $35.00
TOTAL PERMIT FEE DUE:
Z
DISCLAIMER
The permitted verifies, acknowledges and agrees by their signature that: 1) if this permit is for construction or on a dwelling, the dwelling is/will
be served by potable water. 2) Ownership of this City of Spokane Valley permit inure to the property owner. 3) The signatory is the property
owner or has permission to represent the property owner in this transaction. 4) All construction is to be done in full compliance with the City of
Spokane Valley Development code. Referenced codes are available for review at the City of Spokane Valley Permit Center. 5) The City of
Spokane Valley permit is not a permit or approval for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional
information may be required to be submitted and subsequently approved before this application can be processed.
Signature
Date: //- /J-- o,S-
Method of payment: [Cash ❑ Check ❑ Visa ❑ Mastercard
Bankcard #: EXP: VIN#:
Authorized Sionature:
Effective October 28, 2007 Page 2 of 2
http://www.spokanevaIley.org/uploads/Community_Development/Documents/Forms/Building/Mechancial Permit App.l.doc
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 min. AFUE ratin
Equal to or less than 400.000
X
$50.00 =
6
USED APPLIANCE (WSEC 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
BOILER/REFRIGERATION
501 - 1 OOOM 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 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
1 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
4-15 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 = S
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 =
SUBTOTAL
PROCESSING FEE $35.00
TOTAL PERMIT FEE DUE:
Z
DISCLAIMER
The permitted verifies, acknowledges and agrees by their signature that: 1) if this permit is for construction or on a dwelling, the dwelling is/will
be served by potable water. 2) Ownership of this City of Spokane Valley permit inure to the property owner. 3) The signatory is the property
owner or has permission to represent the property owner in this transaction. 4) All construction is to be done in full compliance with the City of
Spokane Valley Development code. Referenced codes are available for review at the City of Spokane Valley Permit Center. 5) The City of
Spokane Valley permit is not a permit or approval for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional
information may be required to be submitted and subsequently approved before this application can be processed.
Signature
Date: //- /J-- o,S-
Method of payment: [Cash ❑ Check ❑ Visa ❑ Mastercard
Bankcard #: EXP: VIN#:
Authorized Sionature:
Effective October 28, 2007 Page 2 of 2
http://www.spokanevaIley.org/uploads/Community_Development/Documents/Forms/Building/Mechancial Permit App.l.doc