2007, 07-24 Permit App: 07002874 Heat Pump/ACPermit Center
11703 E Sprague Ave, Suite 8-3 �
pOke2i1@ Spokane Valley, WA 9206 PERMIT NUMBER:
Ville (509X688-0036 FAX (509)689-0037 �
Community Development
www.sn0fancvaliev.or� PERMIT FEE:
Mechanical Application ❑ Commercial � Residential
SITE ADDRESS:
Building Owner
DESCRIPTION OF WORK
✓ /
0 OF UNITS X
COST TOTAL AMOUNT
1
FUEL BURNING APPLIANCE
Name:
Phone:
_
3 tC�
Fac:
I X
Address: /
City:
i
r
State:
Zip:
Contractor
More than 400,000
X
$100.00
5
USED APPLIANCE SEC min. AFUE rating)I
Equal to or less than 400,000
Name:
��
.Phone:
_
/
i•ax. EW
45;,L
Address:
BOILER/REFRIGERATION
City:
X
$12.00 -
Stale:
--
Zip:
License No:
�✓
City Bu4ness
Lic:
BOILER/REFRIGERATION I
501 - 1,000M BTU
I X
Contaet
10
BOILERIREFRIGERATION
1,001 - _1760M BTU
i X
$35.00 -
11
Name:
n
Phone:
$60.00 i
_
GAS LOG, GAS INSERT, GAS FIREPLACE
[U I F'.IK MRINULtIl UvhJ NO I include do ng
DESCRIPTION OF WORK
✓ /
0 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
I X
$15.00
3
UNLISTED APPLIANCE Additional Fee
E ual to or less than 400.000
X
$50.00
4
UNLISTED APPLIANCE Additional Fes
More than 400,000
X
$100.00
5
USED APPLIANCE SEC min. AFUE rating)I
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 -
6
BOILER/REFRIGERATION
101 - 500M BTU
X
$20.00 -
9
BOILER/REFRIGERATION I
501 - 1,000M BTU
I X
$25.00 = i
10
BOILERIREFRIGERATION
1,001 - _1760M BTU
i X
$35.00 -
11
BOILERIREFRIGERATION
More than 1,750M BTU
i X
$60.00 i
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
LmISC. FUEL BURNING APPLIANCE
X
$10.00 -
17
1 GAS PIPING each ouUet)_
X
[U I F'.IK MRINULtIl UvhJ NO I include do ng
Equal to or less than 10.000 CFM I
I X
; $12,00 1= 1
1 21 AIR HANDLER DOES NOT include ducting)
Greater than 10,000 CFM
X
$15.00 -
22 EVAPORATIVE COOLERS
I
X
$10.00
23 TYPE I HOOD
X
X
$50.00 -
24 TYPE 11 HOOD
$12.00 _ 1
X
$10.00 I =
25 HEAT PUMP/AIR CONDITIONER
0-3 TON
X
$12.00 -
26 I AIR CONDITIONER
4-15 TON
X
$20.00
__ AIR CONDITIONER
! 15-30 TON
I X
$25.00 =
ca HIR LVNUI t IVNtKI More than 50 TON
X 1
$60.00 = i
30 LPG STORAGE TANK
X 1
$10.00 -
31 WOOD OR PELLET STOVE/INSERT
X 1
$10.00 -
32 WOOD STOVE - FREE STANDING
X
$25.00 -
1 33 1 REPAIR & ADDITIONS j
X
$15.00 = I
34 VENTILATION SYSTEMS
I X
$12.00 _ 1
35 VENTILATION MECHANICAL EXHAUST
X
$12.00 -
36 INCINERATOR - RESIDENCE
X
$19.00 =
37 INCINERATOR - COMMERCIAL
x$22.00
-
METHOD OF PAYMENT:
❑CASH ® CHECK ❑ VISA M MC EXPIRES:
CARD #: VIN:
AUTHORIZED STGNA'IURE: r �� j
REVISED si26105
SUBTOTAL I0
PROCESSING FEE $35.00
TOTAL PERMIT FEE DUE: I , O