2004, 09-13 Permit App BLD-04-07630 Mechanical FixturessolValley
MECHANICAL PERMIT APPLICATION
City of Spokane Valley Coniinuniy Development Department
BuitdtngDivision
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
FOR INSPECTIONS, CALL (509) 688-0054
Project Address: 1-192. (o C 133 ro c to eLA-1_, Permit Use:
Owner-%/%�% o�% / e rL� %� sw� _ Phone (Daytime Contact):
Address:,d9Zt9 E
Contractor.
Mailing Address:
License #:
City
State
Phone #:
Zip Code
DESCRIPTION OF WORK
# OF
UNITS
X
COST
=
TOTAL
AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
j
X
515.00
=
15. 0
2
FUEL-APPLL NCt
retatani00.000
$14.00
=
3
UNLISTED APPLIANCE (Additional Fee)
Equal to or less than 400 000
_X
X
$50.00
=
4
UNLISTED APPLIANCE
More than 400 000
X
$100.00
=
(Additional Fee)
5
USED APPLIANCE (WSEC min. AFUE
rating)
Equal to oriess than 400,000
X
$50.00
=
8
USEO APPLIANCE (WSEC min. AFUE
rating)
Morethan400,000
X
3100.00
=
7
BOILER/REFRIGERATION
1 - 100M BTU •
X
$15.00
=
8
B011ER1REFRIGERATION
101 - 500M BTU
X
526.00
=
9
BOILER/REFRIGERATION
501-1,000M BTU
X
$39.00
=
10
BOILER/REFRIGERATION
1,001 - 1,750M BTU
X
$57.00
=
t1
BOLLR/REFRIGERATION
More than 1 750M BTU
X
$95.00
=
12
GAS LOG, GAS INSERT, GAS FIREPLACE
X
$10.00
=
13
RANGE -
X
$1Q,00
=
14
DRYER
X
510.00
=
15
FUEL BURNING WATER HEATER
X
$10.00
=
16
MISC. FUEL BURNING APPLIANCE
X
$10.00.
=
. 17
(=AS PIPING (eacb outlet)
I
X
51.00
=
I . O 0
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
AIRHANDLER(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 It HOOD
X
S10.00
=
25
HEATPUMP/AIR CONDITIONER
0-3 TON
j
1
X
_
51200
=
,'7 0 6
26
AIR CONDITIONER
3-15 TON
X
$20.00
=
,
27
AIR CONDITIONER
15-30TON
X
$25,00
=
28
AIR CONDITIONER
30-SITON
X
$35.00
=
29
AIR CONDITIONER
More than 50 TON
-
X
$60.00
=
30
. LPG STORAGE TANK
_
X
510.00
=
• 31
WOOD OR PELLET STOVE/INSERT
-
_
X
510.00
=
32
X
525M0
=
WOOD -STOVE -FREESTANDING
METHOD OF PAYMENT:
0 CASH 0 CHECK 0 VISA 0 MC
CARD!!'
DATE:
SUBTOTAL
2 Fj 4 0
PROCESSING FEE
l.// � $35..00�
Y3-vl9
EXPIRES:
TOTAL PERMIT FEE DUE
Zip Code
AUTHORIZED SIGNATURE: