2007, 03-15 Permit App: 07000812 Mechanical FixturesPermit Center
Spb`kane 11707 E Sprague Ave, Suite 106 PERMIT NUMBER: 0 -"
sValley Spokane Valley, WA 99206
�/ (509)688-0036 FAX: (509)688-0037 PERMIT FEE:
Community Development www.spokaneVallev.ore
Mechanical Permit Application ❑ Commercial _M Residential
TA -
SITE ADDRESS: i 3 V2 I 3 G! KA R }00
Building Owner
DESCRIPTION OF WORK
Name: , G�
Phone: iCt _ '� (3 6"(
Fax:
Address: �'� l 3 (i
City: c,e W
State: 14 Zip: 1jeje 3 -7
Contractor
$12.00
= 1,20&
Name: FM w�/ , ^
i�I ,
Phone: `7l d - t) -7 q
S4,y
Fax: 5 e' cf� i 2 G S C% G
Address:( 5 . A n;
`/
City: v C, / 5
State: Zip: c '10 3 -7
License No: 9 T G
City Business Lie:
Equal to or less than 400,000
Contact
$50.00
=
Name:
Phone:
More than 400,000
AUTHORIZED SIGNATURE:
REVISED 8126/05
DESCRIPTION OF WORK
# OF UNITS X
COST
= I TOTAL AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
X
$12.00
= 1,20&
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 SEC min. AFUE ratio
Equal to or less than 400,000
X
$50.00
=
6
USED APPLIANCE SEC min. AFUE ratio
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
= 1
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
=612,00
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:
❑CASH ❑ CHECK AVISA ❑ MC
CARD #:
EXPIRES:
VIN:
SUBTOTAL
PROCESSING FEE
TOTAL PERMIT FEE DUE:
5 -
$35.00
%G . E 0
AUTHORIZED SIGNATURE:
REVISED 8126/05