2005, 06-27 Permit App: 05002194 Furnace, ACS"p��kane .
1_..0Valley
-Mechanical Permit Application
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206 509-688-0037 - Fax
For inspections, call 509-688-0054
PROJECT
ADDRESS: 821 , { .cE ..cr-r-
PERMIT
USE:
OWNER n m iib LG,, f„,9_,„
PHONE (Daytime Contact): q q ....-7q 6 /
MAILING ADDRESS:
F.,/ 2' s7 1/-4/9.. 0 C�1()�-ggU37
(street) (city/state) (ZIP)
NIR
CO/' A� nie,LE7L/ lira,. 1000 ,
LICENSE f: Ve L 67 0,I C 0
MAILING ADDRESS:
.
SPg4!amu
PHONE4:
3e-ff.E3oS"
r/i-= Zfifi 9962 e ---.
I s, 000 .r, st()4--'4
.
(street) (city/state) (ZIP)
METHOD OF PA
❑ CASH D CHECK 0 0
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
3 OF UNITS
X
COST
EQUALS
AMOUNT
1
FUEL BURNING APPLIANCE
• OR < 100,030
t
X
1$5✓
•
I Z.- v O
2
FUEL BURNING APPLIANCE
> 100,000
X
519
-
3
UNLISTED APPLIANCE (ADDmONAL FEE)
- OR<400,000
X
550
•
4
UNLISTED APPLIANCE (ADDITIONAL FEE)
> 400,000
X
5100
•
5
USED APPLIANCE (WSEC min. AFUE rating)
• or < 400,000
X
550
•
6
USED APPLIANCE (WSEC min. AFUE rating)
> 400,000
X
5100
•
7
BOILER/REFRIGERATION
1 - 100M BTU
X
515
•
8
BOILER/REFRIGERATION
101- 500M BTU
'X
528
-
9
BOILER/REFRIGERATION
501-1,000M BTU
`
X
$39
•
10
BOILER/REFRIGERATION
1001. 1,750M BTU
X .
557
•
11
BOILER/REFRIGERATION
•1750M BTU
X
S95
•
12
GAS LOC, GAS INSERT, GAS FIREPLACE
-
X
510
•
13
RANGE
-
X
510
•
y
14
DRYER
-
X
510
-
15
FUEL BURNING WATER HEATER
--
X
. 510
•
16
MISC FUEL BURNING APPL.
-
X
510
-
17
GAS PIPING (ea. Outlet)
-
1
X
51
•
+ .
18
DUCT SYSTEMS
-
X
510
•
19
VENTILATING FANS
-
X
510
•
20
AIR HANDLER (DOES NOT Include ducting)
• OR < 10,000CFM
X
512
-
21
AIR HANDLER (DOES NOT Include ducting)
> 10,000 CFM
X
519
•
.
22
EVAPORATIVE COOLERS
-
X
510
•
23
TYPE I HOOD
-
X
550
-
24
TYPE II HOOD
-
X
510
•
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
X
512
•
26
AIR CONDITIONER
3-15 TON
1
X
520
-
Z 0 . OD
27
AIR CONDMONER
15-30 TON
X
525
-
28
AIRCONDMON£R
30-50 TON
X
535
-
29
AIR CONDITIONER
+50 TON
X
560
•
30
LPG STORAGE TANK
-
X
510
-
31
WOOD OR PELLET STOVE/INSERT
-
X
510
-
32
WOOD STOVE - FREE STANDING
--
X
525
•
KENT.
_"•^
SUBTOTAL:
PLUS PROCESSING FEE:
$35.00
TOTAL PERMIT FEE DUE:
❑ CASH D CHECK 0 0
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: