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MECHANICAL FIXTURES
# OF
UNITS
x COST / UNIT = AMOUNT
Evaporative Coolers x $12.00 =
Gas Fireplace x $12.00 =
Gas & Hydronic Piping x $12.00 + $1.00 per outlet =
Gas Water Heater x $12.00 =
Heating Equipment < 100,000 btu x $15.00 =
Heating Equipment >100,000 btu x $20.00 =
Hydrostatic Pressure Test x $35.00 =
Miscellaneous x $12.00 =
Propane Tanks x $35.00 =
Range x $12.00 =
Refrigeration Equipment (1 – 100,000 btu) x $15.00 =
Refrigeration (101,000
500,000 btu) x $25.00 =
Refrigeration (501,000
1,000,000 btu) x $35.00 =
Refrigeration (1,000,000
1,750,000 btu) x $45.00 =
Refrigeration (> 1,750,000 btu) x $65.00 =
Type I Hood x $60.00 =
Type II Hood x $12.00 =
Ventilating Fans x $12.00 =
Unlisted Gas Appliance < 400,000 btu x $75.00 =
Unlisted Gas Appliance > 400,000 btu x $125.00 =
Used Gas Appliance < 400,000 btu x $75.00 =
Used Gas Appliance > 400,000 btu x $125.00 =
Woodstove / Insert & Pellet Stove / Insert x $25.00 =
BY SIGNING BELOW, I AC
KNOWLEDGE THAT IT IS MY RESPONSIBILITY TO ENSURE REQUIRED INSPECTIONS ARE
COMPLETED AND REQUESTED WITH A MINIMUM OF 24 HOURS NOTICE.
Applicant's Signature (REQUIRED) Printed Name Date
PLEASE MAKE CHECKS PAYABLE
TO CITY OF LIBERTY LAKE
SUBTOTAL
PLUS PROCESSING & TECHNOLOGY FEE
$ 40.00
TOTAL PERMIT FEE DUE
Permit Issuance Option
Would you like to receive your permit / approved plans via email? Yes No
(If yes, please complete the portion below. Once review of your application is complete, we will contact you for credit card payment via phone. You will
be required to print the permit, inspection card, and approved plans for the job site.)
The permit becomes null and void if work or construction authorized by the permit is not commenced within 180 days of
issuance or if construction or work is suspended or abandoned for a period of 180 days at any time after work is
commenced, unless an extension is granted. Issuance of this permit does not give the authority to violate any federal,
state, or local laws or ordinances, or the building code regulating construction. Separate permits (building, plumbing,
mechanical, sewer, water connection, electrical, etc.) may be required for work performed on this site. Additional permits
/plans may be required prior to Certificate of Occupancy issuance. Contact SRCAA at 509-477-4727 and/or visit
www.spokanecleanair.org to ensure compliance with air quality regulations. The applicant shall be responsible for
obtaining additional permits/approvals from affected agencies. By checking the box below, I certify that I have read and
understand all of the conditions contained herein and I have the authority to sign on behalf of the applicant. Additionally, I
certify that my signature included on the permit, if done by electronic means, provides the same understanding and
authorit
as if I had si
ned the permit in person or writin
.
BY SIGNING BELOW, I GIVE MY PERMISSION FOR USE OF MY ELECTRONIC SIGNATURE ON THE PERMIT AND I
ACKNOWLEDGE THAT I UNDERSTAND AND AGREE TO THE TERMS DESCRIBED ABOVE.
Applicant's Signature Printed Name Date
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signature
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