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2008, 06-09 Permit App: 08002170 Mechanical Fixtures%� (Staff Use Only) c�ry or la S PERMIT NUMBER: o�ane ,,;00Valley K PERMIT FEE: 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 perm itcenter(cbspokaneva Iley. org MECHANICAL PERMIT APPLICATION QCOMMERCIAL ❑' RESIDENTIAL SITE ADDRESS: /�. BUILDING OWNER NAME: 1,1 r�_t(; F NAME: MELISSA TEICHMER ADDRESS: 11005 E. 24TH CITY:SPOKANE STATE:WA ZIP:99206 PHONE: 5099241264 FAX: CELL:9933242 CONTACT NAMEWELISSA PHONE: FAX: CELL: CONTRACTOR NAME: MAILING ADDRESS: CA PQ"fiK_' �OD 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.spokanevaIley.org/uploads/Community_Development/Documents/Forms/Building/Mechancial Permit App.1.doc 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: Method of payment: ❑ Cash ❑ Check ❑ Visa ❑ Mastercard Bankcard #: Authorized Signature: EXP: VIN#: Effective October 28, 2007 Page 2 of 2 http://www.spokanevalley.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 000X 15.00 - 3 UNLISTED APPLIANCE Additional Fee Equal to or less than 400,000 $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 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 ductin 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 $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 - SUBTOTAL PROCESSING FEE TOTAL PERMIT FEE DUE: r / &V 35.00 1 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: Method of payment: ❑ Cash ❑ Check ❑ Visa ❑ Mastercard Bankcard #: Authorized Signature: EXP: VIN#: Effective October 28, 2007 Page 2 of 2 http://www.spokanevalley.org/uploads/Community_Development/Documents/Forms/Building/Mechancial Permit App.l.doc