2005, 03-04 Permit App: 05000673 Pellet Stove 6573.
MECHANICAL PERMIT APPLICATION Community Development Department
Building Division
, V t Phone: (509) 688-0036; FAX: (509) 688-0037 11707 E. Sprague Avenue, Suite 106
dl For Inspections, Call (509)688-0054 Spokane Valley, WA 99206
Project Address: 1 3 .3 C 7 1. z 2- 0 Permit Use:
Owner: C.Y J-0144 u.1�,5 i= Phone (Daytime Confact): -5O y X77-776 7-
Mailing Address: ,Si4N1 4 _510,.› ,4 r= U y GJ 4- Y Y o3 7
City State Zip Code
Contractor: License#: Phone#:
Mailing Address:
City State Zip Code
DESCRIPTION OF WORK #OF UNITS X COST , = TOTAL AMOUNT
1 FUEL BURNING APPLIANCE Equal to or less than 100,000 X $72.00 =
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 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/REFRIGERAT1ON 101 -500M BTU X $20.00 =
9 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 RANGEX $10.00 =
14 DRYER _ X $10.00 y =
15 FUEL BURNING WATER HEATER X $10.00 =
16 MISC.FUEL BURNING APPLIANCE .. $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 1 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 CONDITIONER30-50 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 I 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
9 CASH ❑CHECK IDVISA 0 MC DATE: PROCESSING FEE $35.00
CARD#: EXPIRES: TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE: