2007, 08-02 Permit App: 07003021 Furnace, AC �N,=.,,, Permit Center 01-30Z.‘,
Spolcane11707E Sprague Ave,Suite 106
Spokane Valley,WA 99206 PERMIT NUMBER
• (509)688-0036 FAX:(509)688-0037 PERMIT FEE: 6 t cc
Community Development www.spokanevallev org �,
Mechanical Permit Application El Commercial aiesidential
SITE ADDRESS: f 3 s(-- 16.7 2_ r
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Building Owner SUS( G MC G h
Name: N Phone: !/-/ - /3 J"V Fax: n
Address: /1.�(S F, . r6 _ Ctty.�`�0�& 61e VcState: (A)l.7 ' 4'192/4
Contractor 104 rtiot S 0„44.d.
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Name: I Phone: q 7X9 � Fax S 011444.
Address: J y L((•L. c G-( City SitirX4put V tet" State: Lit I Zip 44 V.,4
License No: gc,14, `" n City Business Lic: I'
Contact ,
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Name: - Phone: -7/u --Z.VA V(a C elf/ .._
DESCRIPTION OF WORK #OF UNITS X COST = TOTAL AMOUNT
1 FUEL BURNING APPLIANCE Equal to or less than 100.000 / X $12.00 = /2.Q p
2 FUEL BURNING APPLIANCE - More than 100,000 X $15.00 =
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3 UNLISTED APPLIANCE(Ational 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 =
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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 kiclude 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 11 HOOD - X $10.00 =
25 HEAT PUMP/AIR CONDITIONER 0-3 TON / X $12.00 = /2. Q 11
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 =
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 2 T.Go
DCASH 0 CHECK ❑VISA ❑MC EXPIRES: PROCESSING FEE $35.00
CARD# VIN. TOTAL PERMIT FEE DUE: ST O d
AUTHORIZED SIGNATURE:
REVISED srz610s