2004, 10-25 Permit App: BLD-04-08023 Mechanical Fixtures�e
galley
Project Adfr�ess:
Owner -
`
Mailing Address: -
Contractor:
Mailing Address:
DESCRIPTION OF WORK
0,, t MECHANICAL PERMIT APPLICATION
City of Spokane Valley Community Development Department
�GJ BuildingDivision
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688-0036, Fax: (509) 688-0£137
_ ff FOR INSPECTIONS, CALL (509) 688-0054
Permit Use:
Phone (Daytime Contact):
11+ K7
.City State , ZI _ ode
License #: `� Phone #: -
G
State Zip Code
00F TOTAL
UN s. I X COST _- AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
$15.00
—2—
FUEL SURWINGAPPLIANCE- - - -
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-
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$1S.00
3
UNLISTED APPLIANCE Additional Fee
Equal to or less than 400,000
$50.00 =
4
UNLISTED APPLIANCE Additional Fee
More than 400 000
$100.00 =
5
USED APPLIANCE (WSEC min, AFUE
call
Equal to or less than 400,000
X
$50.00 =
6
USED APPLIANCE (WSEC min. AFUE
rat'
More than 400 000
X
$100.00 =
7
BOILER/REFRIGERATION
1 - loom BTU •
X
$15.00 =
a
BOILER(REFRIGERATION
101 - 500M BTU
X
$28.00 =
9
BOILERIREFRIGERATION
501 - 1,000M BTU
X
=
10
BOILERIREFRIGERATION
1,0.01-1,750MBTU
X
=
1t
BOILETUREFRIGERATION
More than 1,750M BTU
X
=
12
GAS LOG GAS INSERT, GAS FIREPLACE
X
=
r,
v
13
RANGE
X
=
!1.aa
14
DRYER
X
15
FUEL BURNING WATER HEATER
X
16
MISC. FUELBURNINGAPPLIANCE
X
17
GAS PIPING each outlet
X
=
I l8
DUCT SYSTEMS
X
S" — _
19
VENTILATINGFANS
X
$10.00 =
20
AIR HANDLER DOES NOT include ducting)
Equal to or less than 10,000 CFM
X
$1200 =
21
AIR HANDLER DOES NOT include ducting)
Greater than 10,000 CFM
X
$19.00 =
22
EVAPORATIVE COOLERS
X
$10.00 =
23
TYPE I HOOD
X
$50.00 =
24
TYPE It HOOD
X
$10.00 =
25
HEAT PUMPtAIR CONDITIONER
O3 TON
X
512.00 =
26
AIR CONDFRONER
3-15 TON
X
$20.00 =
27
AIR CONDITIONER
15-3DTON
X
$25,Oo =
2&
AIR CONDITIONER
30-50TON
X
$35.00 =
29
AIR CONDITIONER
More than 50TON
X
$60.00 =
30
LPG STORAGE TANK
X
$10,00 =
31
WOOD OR PELLET STOVEIINSERT
X
510.00 =
32
i WOOD STOVE - FREE STANDING
X
$25,00 =
METHOD OF PAYMENT:
❑ CASH ❑ CHECK ❑ VISA 0 MC
cARn t-
DATE:
SUBTOTAL
PROCESSING FEE
TOTAL TOTAL PERMIT FEE DUE:
$35.00,/
U�
AUTHORIZED SIGNATURE: