2007, 08-22 Permit App: 07003307 Range, Piping r •
Permit Center
olJ e ��► 11703 E Sprague Ave,Suite B-3
Spokane Valley,WA 99206 PERMIT NUMBER: 5�07
40,00Valley` (509)688-0036 FAX:(509)688-0037 PERMIT FEE:
Community Development www.sookanevalley.ore Q
Mechanical Permit Application ❑ Commercial ❑ Residential
SITE ADDRESS: /6 �/ 5 E- a 3 •l•J ,' -' /fir-r_ 4 o )/6,-- ), 4-2/-07 '520,37
Building Owner
Name: /04" ,-1 e,.1 c,f'1 Phone: 47 77,..../77 U Fax:
Address: / J 7 c /- 7,-.-/ /9,.�. City:�., K---. 1 (/G �y' �U�
State: Zip: 7
Contractor d'1
Name: Phone: Fax:
Address: City: State: Zip:
License No: City Business Lie:
Contact
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(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/REFRIGERATION 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 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 FANSX $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 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 =
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 //
OCASH ElCHECK 0 VISA ❑MC EXPIRES: PROCESSING FEE $35.00
VIN:
CARD#: TOTAL PERMIT FEE DUE: L/c
AUTHORIZED SIGNATURE: --.-"._"............. .. . .
REVISED 8/26/05