2007, 08-30 Permit App 07003430 Fuel Brng Appl Permit Center
C^+T�7>�ne 11703 E Sprague Ave,Suite B-3 �4_C)
p lia Spokane Valley,WA 99206• PERMIT NUMBER:
loperis\dlley' (509)688-0036 FAX:(509)688-0037 PERMIT FEE: 41 ----
Community Development www.spokanevalley.org
Mechanical Permit Application n Commercial XResidential
s SITE ADDRESS: /o0 S, D/5*L4//f70 /\13 -
Building Owner 7iy, ,L YyD Tn.,,f ,j�/
Name: 1 (
9 1 1�� Phone:J!Q%)_2//.,..7/ 2 Fax:J/6)?_77 422y9
Address: /Qe)S s . �JSl/i-* y✓ , . City:, (/�i T ,/1 1. State:G� L Zip:y9
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Contractor T i
Name: Phone: Fax:
Address: City: State: Zip:
License No: City Business Lic:
Contact
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 = /c , O 0
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 I $10.00 =
17 GAS PIPING(each outlet) X $1.00 =
1
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 8 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 4 /i C V
❑CASH IDCHECK ElVISA ❑MC EXPIRES: PROCESSING FEE $35.00
CARD#: ` VIN. TOTAL PERMIT FEE DUE: LO-Ov
AUTHORIZED SIGNATURE: - .
REVISED 8/26/05 � -�