2005, 03-25 Permit App: 05000922 Furnace 'MECHANICAL PERM614 APPLICATION Community Development Departmen
Building Divisior
LIi Phone: (509) 688-0036; FAX: (509) 688-0037 11707 E. Sprague Avenue, Suite 10E
Ydl For Inspections, Call (509) 688-0054 Spokane Valley, WA 9920E
Project Address: I . ,) E 11L h Permit Use:
Owner: rA r s+,,-P• 1,1" rS (,,, t,t tl Lk'LN,c Phone paytime Confect): -D r I
Mailing Address: .5 0.vtA c ../x-)ICuy,k Ui moi .. cf.
City State Zip ode
Contractor: ti(}0 - 6 (3;4,,r k \zv'..'1(.:4 License#: (--CCW4II C e.5 K 1l Li, Phone#: (n(-3`11 I
Mailing Address: kCI0a,a YJ , /...or .,:4 I'- 9n I�a,..w l !I 1.,1 A. 9 .)ii-i6
1 City 1 State Zip Code
DESCRIPTION OF WORK #OF UNITS X1 COST I = TOTAL AMOUNT
1 FUEL BURNING APPLIANCE Equal to or less than 100,000 , X $12.00 = I .
•
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 400,000X $50.00 =
6 USED APPLIANCE(WSEC min.AFUE rating) More than 400,000 4 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 510.00 =
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 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 510.00. =
25 HEAT PUMP/AIR CONDITIONER 0-3 TON X $12.00 =
•
26 .AIR CONDITIONER. 3-15 TON X $20.00 =
27 AIR CONDITIONER15-30 TON 4 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&ADDITIONSX $15.00 =
34 VENTILATION SYSTEMS X ' $12.00
35 VENTILATION MECHANICAL EXHAUST X $12.00 =
_36 INCINERATOR-RESIDENCE 1 X $19.00 _
37 INCINERATOR-COMMERCIAL X $22.00 = .
METHOD OF PAYMENT: SUBTOTAL `�
• 0 CASH 0 CHECK 0 VISA 0 MC DATE: PROCESSING FEE $35.00
CARD#: EXPIRES: TOTAL PERMIT FEE DUE: l
AUTHORIZED SIGNATURE: