2005, 03-16 Permit App: 05000776 Furnace MECHANICAL PERMIT APPLICATION Community Development Departmen
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ryrn�(� Building Divisior
'e"""'� Phone: (509) 688-0036; FAX: (509) 688-0037 11707 E. Sprague Avenue, Suite 10E
For Inspections, Call (509) 688-0054 Spokane Valley, WA 9920E
Project Addr-ss: 1 (' r(1 W F' 3 5 1" Permit Use:
Owner: l . . Phone (Daytime Confact): _ DI
Mailing Address: kb.• ((p '?( 6 1,1 1 [..J 4. 9',-9',-)6/,,O
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Contractor: HOME CC)va iv,V �S)(>✓:,C¢f License#: tt()YY1c_C.c . '1112 Z. Phone#: . -c.‘ '? y“-yci//
Mailing Address:
City State Zip Code
DESCRIPTION OF WORK #OF UNITS X COST = TOTAL AMOUNT
1 FUEL BURNING APPLIANCE Equal to or less than 100,000 l X $t2.00 = 17
• _ 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 toor 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 =
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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 t 9,
• 0 CASH 0 CHECK ❑VISA ❑MC DATE: PROCESSING FEE $35.00
EXPIRES: 0
CARD#: TOTAL PERMIT FEE DUE: ��.�
AUTHORIZED SIGNATURE:
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