2005, 06-22 Permit App: 05002104 Inserts, Piping MECHANICAL PERMIT APPLICATION Community Development Department
k ry Building Division
1
40001 ,e,! Phone: (509) 688-0036; FAX: (509) 688 -0037 --- i 11707 E.Sprague Avenue, Suite 106
For Inspections, Call (509) 688-0054
r )01, Spokane Valley, WA 99206
Project Address: ;x`30 7 E. 2V'- Permit Use:
Owner: Ar-t Viot,yi. ? Phone (Daytime Contact):
Mailing Address: o\bn. sloekav t)Al\cj i..1*. 9,206
�1 / City State Zip Code
Contractor: 4cceh l .51ove d Spit License#: A( FN.7S 9S3 j 7 Phone#:(I) 32-5.-8800
Mailing Address: 4,2,2 A), +S,'vs or 40)C-C1 LU Ah 5.gzel 7
City State Zip Code
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 a- _ X $10.00 = 2-0 , 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) 1 X $1.00 = 1, 0 0
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 Z I.DO
0 CASH 0 CHECK 0 VISA 0 MC DATE: PROCESSING FEE $35.00
CARD#: EXPIRES: TOTAL PERMIT FEE DUE: t.,0 0
AUTHORIZED SIGNATURE: