2008, 12-08 Permit App: 08004723 Mechanical Fixtures Permit Center
S Okan�''e_� 11703 E Sprague Ave,Suite B-3 PERMIT NUMBER: Li 1 Z'3
P Spokane Valley,WA 99206
4000Vdlle3y" (509)688-0036 FAX:(509)688-0037 PERMIT FEE: -
Community Development permitcenter@spokanevalley.org
Mechanical Permit Application n Commercial N Residential
SITE ADDRESS: 1 r. > t& C, C 41iiij,(Oh
Building Owner `d t k,t 0 " ‘`"'I'h t}r i" f
t Iry
Name: f, l k. .w r tA-..e..�,..., Phone:c 9_92 2_ J$'L/2 Fax: / 4 �/l�/
Address: 4 D 7 1 g <. C,/'t 1 40,,Li!'U, City:Sy /4 f�.//// State: //,/ Zip: 99r%/v ,
Contractor '�CI7 vGl G w
Name: Vct,t„.-e._r Phone: Fax:
Address: City: State: Zip:
License No: City Business Lic:
Contact s
Name: Phone:
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 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 =
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 ElMC EXPIRES: PROCESSING FEE $35.00
CARD#: VIN' TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
REVISED S/26/05