2004, 07-16 Permit App: BLD-04-07085 Pool Heater, Piping MECHANICAL PERMIT APPLICATION
Snt orne City of Spokane Valley Community Development Department
BuildingDivision
T 11707 E. Sprague Avenue, Suite 106
\ i11eSpokane Valley, WA 99206
Phone: (509)688-0036;Fax: (509)688-0037
FOR INSPECTIONS, CALL(509)688-0054
Project Address: /.0/Y/S 6- X14, , Permit Use: ell(`-t--4-1-
Owner: t'7_Q�-e-ePhone (Daytime Contact):
Mailing Address: /.-� i T- A' a _a L , F.T� ?) V"_ u/u
City State Zip Code
Contractor: ,..i- Y, - License#: Phone#: ,3b: '77 1---
Mailing Address: 1P1.
City State Zip Code
#OF TOTAL
DESCRIPTION OF WORK UNITS X COST = AMOUNT
1 FUEL BURNING APPLIANCE Equal to or less than 100,000 X $15.00 =
2 FUEL BURNING APPLIANCE More than 100,000 X $19.00 ,= ( s
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 =
USED APPLIANCE(WSEC min.AFUE
5 rating) Equal to or less than 400,000 X $50.00 =
USED APPLIANCE(WSEC min.AFUE 0<"
6 rating) More than 400,000 X $100.00 = 1
7 BOILER/REFRIGERATION 1-100M BTU _X $15.00 =
8 BOILER/REFRIGERATION 101-500M BTU X $28.00 =
9 BOILER/REFRIGERATION 501-1,000M BTU X $39.00 = -
10 BOILER/REFRIGERATION 1,001-1,750M BTU X $57.00 =
11 BOILER/REFRIGERATION More than 1,750M BTU X $95.00 =
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 =
/ is e,
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 $19.00 = .
22 EVAPORATIVE COOLERSX $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 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 =
METHOD OF PAYMENT: SUBTOTAL
ciC (C
0 CASH 0 CHECK 0 VISA 0 MC DATE: PROCESSING FEE $35.00
CARD#: EXPIRES: TOTAL PERMIT FEE DUE:
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AUTHORIZED SIGNATURE: