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2004, 01-14 Permit App: BLD-04-03404 Gas PipingaTl c +/, Sp+o'� ime Mechanical Permit Application 11707 East Sprague Ayenue, Suite 106 509-688-0036 - Phone Spokane Valley, WA 99206 509-688-0037 - Fax For Inspections, call 509-688-0054 PROJECT Ni ADDRESS: 1 gV ' 6D(,01 , h PERMIT USE: 9 OF UNITS OWNER 12 j m "y'i cli, f jl/ bOk)1 PHONE (Daytime Contact): 455_ e(Q Q D MAILING ADDRESS: , )4/ 43at ' -.'1 CaoK.44 `'I D •R1 rY1 rrectnet_ - John ,e /S-4° 14-1/411e, wA-�'RG (street) (city/state) (ZIP) CONTRACTOR: LICENSE 11: 515 MAILING ADDRESS: PHONE #: FUEL BURNING APPLIANCE > 100,000 (street) (city/state) (ZIP) METHOD OF PA ❑ CASH C DATE: EXPIRES: BANKCARD NUMBER: AUTHORIZED SIGNATURE: DESCRIPTION OF WORK 9 OF UNITS X COST EQUALS AMOUNT 1 FUEL BURNING APPLIANCE = OR < 100,000 X 515 = 2 FUEL BURNING APPLIANCE > 100,000 X $19 = 3 UNLISTED APPLIANCE (ADDITIONAL FEE) = OR < 400,000 X 550 4 UNLISTED APPLIANCE (ADDITIONAL FEE) > 400,000 X $100 - 5 USED APPLIANCE (WSEC min. AFUE rating) = or < 400,000 X $50 - 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 $28 = 9 BOILER/REFRIGERATION 501 - 1,000M BTU X $39 = 10 BOILER/REFRIGERATION 1001 - 1,750M BTU X $57 = 11 BOILER/REFRIGERATION +1750M BTU X $95 = 12 GAS LOG, GAS INSERT, GAS FIREPLACE - X $10 = 13 RANGE - X 510 = 14 DRYER - X $10 15 FUEL BURNING WATER HEATER -- X $10 = 16 MISC FUEL BURNING APPL. - X 510 = 17 L. GAS PIPING (ea. Outlet) Y W� - 1 X $1 - 18 DUCT SYSTEMS (� - X $10 = 19 VENTILATING FANS - X $10 = 20 AIR HANDLER (DOES NOT include ducting) = OR < 10,000CFM X $12 = 21 AIR HANDLER (DOES NOT include ducting) > 10,000 CFM X $19 = 22 EVAPORATIVE COOLERS - X 510 23 TYPE I HOOD - X $50 = 24 TYPE II HOOD - X $10 = 25 HEAT PUMP/AIR CONDITIONER 0-3 TON X $12 = 26 AIR CONDITIONER 3-15 TON X $20 27 AIR CONDITIONER 15-30 TON X 525 = 28 AIR CONDITIONER 30-50 TON X $35 = 29 AIR CONDITIONER +50 TON X $60 - 30 LPG STORAGE TANK - X $10 = 31 WOOD OR PELLET STOVE/INSERT - X $10 = 32 WOOD STOVE - FREE STANDING - X $25 = MENT } SUBTOTAL: PLUS PROCESSING FEE: $35.00 TOTAL PERMIT FEE DUE: DATE: EXPIRES: BANKCARD NUMBER: AUTHORIZED SIGNATURE: