2008, 12-17 Permit App: 08004812 Piping « Permit Center
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/ S okan 11703E Sprague Ave,Suite B-30
Spokane Valley,WA 99206 PERMIT NUMBER: I
jValley (509)688-0036 FAX:(509)688-0037 PERMIT FEE: '3 6.CZ).
Community Development permiteenter@spokanevalley.org
spokanevalley.org
Mechanical Permit Application n Commercial [,Residential
SITE ADDRESS: I Li y i 1 F 4 T4 4 U G - ,S i ?ku l') Li'll 47 k, 4 2 'C 3 7
Building Owner
Name: Sc }^ (zr .Fl
/e. o Phone:,�c j `/%1,- 7_2s 3~ Fax:
Address: / t y, City: 3/1714,0 `ji``. State: Zip: < -7
yy/s £ � �L� U I.✓A Il- /
Contractor
Name: (7 14 I/d e t,- Phone: Fax:
Address: 1 City: State: Zip:
License No: City Business Lic:
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 , _ /,,v7
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
['CASH CHECK 0 VISA 0 MC EXPIRES: PROCESSING FEE $35.00
CARD#: VIN: TOTAL PERMIT FEE DUE: ^CY
AUTHORIZED SIGNATURE:
REVISED 8/26/05