2003, 11-06 Permit App: BLD-03-02996 Mechanical FixturesS°pokane�°''
do#Valley
Mechanical Permit Application
X03')cQ&
11707 East $`rague Avenue, Suite 106 509-688-0036 - Phone
509-688-0037 - Fax
Spokane Valley, WA 99206
METHOD OF PA
❑ CASH D C
DESCRIPTION OF WORK
# OF UMTS
PROJECT
ADDRESS: , 7 3
COST
m Q -
PERMIT
USE:
"�
1 / F
P1^ ^ YA--'n
OWNER: ,V r+, t—I IRt tactY 1
PHONE (Daytime Contact):
MAILING ADDRESS:
i73\ 7
t- BCON1e-
0,0C-Q—Cv-5
919(01 CC)
(street)
FUEL BURNING APPLIANCE r
(city/state)
(ZIP)
CONTRACTOR:
L z'v\..) Q. f---
SI9
LICENSE #:
MAILING ADDRESS--•
UNLISTED APPLIANCE(ADDITIONAL FEE)
PHONE #:
X
550
(street)
(city/state)
(ZIP)
> 400,000
X -
$100
METHOD OF PA
❑ CASH D C
DATE: EX-PIREg
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
# OF UMTS
X
COST
EQUALS
AMOUNT
1
FUEL BURNING APPLIANCE
.- OR <100,000
X
' $15
-
2
FUEL BURNING APPLIANCE r
> 100,000
. X '
SI9
-
3
UNLISTED APPLIANCE(ADDITIONAL FEE)
-OR<400,000
X
550
-
4.
UNLISTED APPLIANCE (ADDIIIONAL FEE)
> 400,000
X -
$100
-
5
USED APPLIANCE (WSEC min. AFUE rating)
- of <400,000
X
. 550
-
6
USED APPLIANCE (WSEC min: AFUErBting)
>400,000
- ..
X
$100
-
7
BOILER/REFRIGERATION
I - 100M BTU
X
S15 '
-
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
557
-
11
BOILER/REFRIGERATION
+1750M BTU
X
595
-
12
GAS LOG, GAS INSERT, GAS FIREPLACE
-
X
SIO .
- - .
13
RANGE •
-
X
110
-
14
DRYER'
-
X
510
15
FUEL BURNING WATER HEATER -
-
-
X
$10
•
16
MSC FUEL BURNIN_ AREL
.... __......
__--. ..
....X... _
_ .
-;
17
GAS PIPING (ea. Outlet)
- -
(
X
$1
•
18
DUCT SYSTEMS
-
X
S10
•
19
VENTILATING FANS
-
-
X
S10
-
20
AIR HANDLER (DOES NOT Include ducting)
• OR < 10.000CFM
X
SII
- -
21
AIR HANDLER (DOES NOT include ducting)
> 10,000 CFM
X
519
-
22
EVAPORATIVE COOLERS
- -
X
$10
• -
23
TYPE I HOOD _
-
X
150
24
TYPE IIHOOD -
-
X
S10
•
25
HEAT PUMP/ARI CONDITIONER •
0-3 TON
X
512
•
26
AIR CONDITIONER -
3-15 TON
X -
S20
-
27
AIR CONDITIONER
15-30 TON
X
$25 '
-
28
AIR CONDITIONER
30-50 TON
X
535
-
29
AIRCONDITIONER
+50 TON
X
560
•
30
LPG STORAGE TANK
-
X
$10
•
31
WOOD OR PELLET STOVE/INSERT
-
X
' S10
•
32
WOOD STOVE -FREESTANDING
-
X
525
•
KENT -
r- :yr
y/$q- i�wf_a6
. SUBTOTAL:
I.00
PLUS PROCESSING FEE
$35.00 -
TOTAL PERMIT FEE DUE: 3(91 00
DATE: EX-PIREg
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: