2004, 04-22 Permit App BLD-04-04172 Range�0 1^14014hjne
Project Addre s: �-7D4
Owner:
Mailing Address: -
Contractor: c_,t-L�
Mailing Address:-
,[, C�5Y-Y�,, I, -
MECHANICAL PERMIT APPLICATION
City of Spokane Valley Community Development Department
BuildingDivision
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
{� Phone: (509) 688-0036; Fax: (509) 688-0037
`�t"1 C) , FOR INSPECTIONS, CALL (509) 688-0054
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Permit Use:
Phone (Daytime Contact): ) �51 - o �D-'
CityState
#: r, Phone #:
City State
AUTHORIZED SIGNATURE:
Zip
DESCRIPTION OF WORK
# OF
UNITS X
TOTAL
COST = AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
X
$15.00 =
2
FUEL BURNING APPLIANCE
More than 100,000
X
$19.00 =
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
ratio
More than 400,000
X
$100.00 -
7
BOILER/REFRIGERATION
1 - 100M BTU
X
$15.00 =
8
BOILER/REFRIGERATION
101 - 500MBTU
X
$28.00 -
9
BOILER/REFRIGERATION
501 - 1,000M BTU
X
$39.00 -
10
BOILER/REFRIGERATION
1,001 - 1,750M BTU
X
$57.00 -
11
BOILERIREFRIGERATION
More than 1,750M BTU
X
$95.00 =
12
GAS LOG, GAS INSERT, GAS FIREPLACE
X
$10.00 =
RANGE
X
$10.00 -
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
$19.00 =
22
EVAPORATIVE COOLERS
X
$10.00 =
23
TYPE I HOOD
X
$50.00 =
24
TYPE II HOOD
X 1
$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 1
$25.00 -
METHOD OF PAYMENT:
❑ CASH ❑ CHECK ❑ VISA ❑ MC
CARD #:
DATE:
EXPIRES:
SUBTOTAL
PROCESSING FEE $35.00
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
Zip