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2005, 09-02 Permit App: 05003222 Mechanical FixturesSpokan e`er'` Malley Community Development Mechanical Permit Application o Commercial Permit Center 11707 E Sprague Ave, Suite 106 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 www.svokanevalley.ora.com • SITE ADDRESS LL j7Residen tia1 / y9,0 2 e -2 VA -v EP . h e • w,4 9 9o37 Building owner. j% Name: f �[ vl�j eM t e ,-5 Phone: Sbel 9,26 4' o 5 ' Fax 1 Address: iU 9 0 2 cc o2 S( htuic CitySAvlwn e U, r State AJ 4 Zip 99037 Contractor Name: O w A Cr- Phone: Fax: Address: City State Zip License No: City Business License No: Contact Name:---777inbtgsrjj Phone: C'qf Qa7 - 8864 DESCRIPTION OF WORK I # OF UNITS X COST = TOTAL AMOUNT 1 FUEL BURNING APPLIANCE Equal to or less than 100,000 1 X $12.00 = !„?. Ob 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 = /. U o 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 3-15 TON l X $20.00 = 20 • Ce 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: ❑CASH 0 CHECK ❑ VISA 0 MC DATE: reon EXPIRES: SUBTOTAL PROCESSING FEE $35.00 TOTAL PERMIT FEE DUE: AUTHORIZED SIGNATURE: REVISED 8/26/05