2008, 07-09 Permit App: 08002647 Water Heater _,/�� Permit Center
oka a �► 11703E Sprague Ave,Suite B-3 j ;
Spokane valley,WA 99206 PERMIT NUMBER: '��-c-1
400010Vdller (509)688-0036 FAX:(509)688-0037 PERMIT FEE:
Community Development pennitcentena spokanevalley.org
Mechanical Permit Application ❑ Commercial gResidential
SITE ADDRESS: /.2 72' ;7' .,,4,e
Building Owner 4E.
Name: S4evr Phone: Fax:
Address: 1 P - 14 ,2`Y� Acre City: se,e4,7 e (/C/ley, State: tag_ Zip: 972f
Contractor
Name: SC d IMC 4(I si r Phone: ,sj- 5-0-7 Fax:
Address:
5-z
Address: 14.04 L/•r- City: S��4s9 f ( State: am_ Zip: wzzz
License No: spot rI -_FN.?)3' City Business Lic: K
Contact JY`
Name: &-e v.. Phone: 2/
I._ sc
DESCRIPTION OF WORK c, I ( #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 = /0•C--t)
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 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 /0.,Ct
❑CASH 0 CHECK 0 VISA AOC �j/JEXPIRES: PROCESSING FEE $35.00
CARD#: ����I"��V , TOTAL PERMIT FEE DUE: ��
AUTHORIZED SIGNATURE:
REVISED 8/26/05