2007, 06-11 Permit App: 07002222 Heat Pump, AC Permit Center
•Sj Mkane 11707E Sprague Ave,Suite 106 7�
p Spokane valley,WA 99206 PERMIT NUMBER: --7
PErn000* RMIT
(509)688-0036 FAX:(509)688-0037 PERMIT FEE: 4-1
Community Development `°"'`vspokanevallev.ore
Mechanical Permit vApplication El Commercial ❑ Residential
SITE ADDRESS: 7 U E7 (/��
/ LI C%+M C-7 •
Building Owner /
Name: S v' e p t�C;ti N16, 1 e_a__ Phone: 9'0/1.-c/- 63//:,, Fax:
Address: / °,2 0,5-e L/04l- C7. City: 7 -i�r(- t,0,st iii J State: ,u4.4-- .,u4.4-- . Zip: ,72 L)6
Contractor G'
Name: l (2 `" F C� Phone: L/ _ 7333 3 Fax: 9,)9 5 3 S z 6 5-6
Address: City: C>I')0 v 415----).- State: c.L, y� Zip: ,7 ,2i L
� �1 `7 L 9)L/1 t 1 ()IL...,License No: /A I �Z �L-- -2c.U S 11 City Business Lic:
Contact
Name: -I� Phone: 9 c) %' _ 57 G/
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
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 = /Zi )
26 AIR CONDITIONER 4-15 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
❑CASH 0 CHECK 0 VISA 0 MC EXPIRES: PROCESSING FEE '1$35.00
CARD#: VIN: TOTAL PERMIT FEE DUE: -t �� ��
AUTHORIZED SIGNATURE:
REVISED 8/26/05