2007, 05-14 Permit App: 07001751 Furnace Permit Center
SSiokane 11707E Sprague Ave,Suite 106 PERMIT NUMBER: U (_` (s'
r 40000Valley Spokane Valley,WA 99206
(509)688-0036 FAX:(509)688-0037 PERMIT FEE:
Community Development www.spokanevallev.ore
Mechanical Permit Application r❑ Commercial . itesid�enttial
SITE ADDRESS: ( 3 s( 8 E 'Z �V\ Sp ve-1 f/l-Q OA l(e. G./4
Building Owner +
Name: iV >,I{c( f1 oN o zoo 1 Phone: 2C,/'- ; r i„ Fax:
Address: 2 5" f ipl./E,, a6,77,0‘, jr�
City: ,S'' t°A or, (/a lie State: tiv Zip:
Contractor/• ... T(' k• Gt r r G1 ei f:*4( L j r 7: Co 1",..:1e'p i,..,1r"„r'A/ G"".
Name: r Phone: g2 7. ,,(j?,6 !/e Fax: S G S/1"c.!
Address: / 9' i, .l. t_. c-�"f.�( , City: S Vyli�r';r M•c...t (, lie t
iet x State: LA),
A_ Zip: 9//J
License No: `• t Ro.0 77-,:,t City Business Lic:
Contact s3/t rI ( jr c..1(c.chj1
Name: Phone: _7 /u -2,Z Vt c ei f
DESCRIPTION OF WORK #OF UNITS X COST = TOTAL AMOUNT
1 FUEL BURNING APPLIANCE Equal to or less than 100,000 # X $12.00 = /2. oU
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 =
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 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 / 2.00
❑CASH 0 CHECK 0 VISA ❑MC EXPIRES: PROCESSING FEE $35.00
CARD#: VIN: TOTAL PERMIT FEE DUE: 117.06
AUTHORIZED SIGNATURE:
REVISED 8/26/05