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2008, 02-06 Permit App 08000326 Gas Piping*Wan e Valley Community Development Mechanical Permit Application Permit Center 11703 E Sprague Ave, Suite B-3 Spokane Valley, WA 99206 (509)688-0036 FAX (509)688-0037 www.spokanevalley.org n Commercial PERMIT NUMBER: C. 2L PERMIT FEE: Residential SITE ADDRESS: Building Owner i' c_(l� ✓ e& Name: Phone: GJ3' 3� Fax: Address: •� 0/1 e - R s 33r/ t� /Ll- City: , 9 (h K f Li4i LL L L( State: j Y Ia - Zip: q'7.7i.. Contractor V t0N Name: Phone: Fax: Address: City: State: Zip: License No: City Business Lic: Contact Name: Phone: DESCRIPTION OF WORK # OF UNITS X COST = TOTAL AMOUNT 2 3 4 5 6 7 FUEL BURNING APPLIANCE FUEL BURNING APPLIANCE UNLISTED APPLIANCE (Additional Fee) UNLISTED APPLIANCE (Additional Fee) USED APPLIANCE (WSEC min. AFUE rating) USED APPLIANCE (WSEC min. AFUE rating) BOILER/REFRIGERATION Equal to or less than 100,000 More than 100,000 Equal to or less than 400,000 More than 400,000 Equal to or less than 400,000 More than 400,000 1 - 100M BTU x X x X X x $12.00 $15.00 $50.00 $100.00 $50.00 $100.00 $12.00 8 BOILER/REFRIGERATION 101 - 500M BTU X $20.00 9 10 11 12 BOILER/REFRIGERATION BOILER/REFRIGERATION BOILER/REFRIGERATION GAS LOG, GAS INSERT, GAS FIREPLACE 501 - 1,000M BTU 1,001 - 1,750M BTU More than 1,750M BTU x x x X $25.00 $35.00 $60.00 $10.00 13 RANGE X $10.00 14 DRYER $10.00 15 FUEL BURNING WATER HEATER X $10.00 16 MISC. FUEL BURNING APPLIANCE X $10.00 17 18 GAS PIPING (each outlet) DUCT SYSTEMS X X $1.00 $10.00 19 VENTILATING FANS X $10.00 20 21 22 AIR HANDLER (DOES NOT include ducting) AIR HANDLER (DOES NOT include ducting) EVAPORATIVE COOLERS Equal to or less than 10,000 CFM Greater than 10,000 CFM X X X $12.00 $15.00 $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 $19.00 37 INCINERATOR - COMMERCIAL $22.00 METHOD OF PAYMENT: ❑CASH ❑ CHECK ❑ VISA ❑ MC CARD #: AUTHORIZED SIGNATURE: EXPIRES: VIN: SUBTOTAL PROCESSING FEE $35.00 TOTAL PERMIT FEE DUE: Effective 10-28-07 P1Community Development\Forms\Building forms\Mechanical Permit Application.doc