Permit: BD03-163 Pipingane
Valley
Mechanical Per
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206 509-688-0037 - Fax
Application
PROJECT
ADDRESS: IjZ-/ooq,,USE:
DESCRIPTION OF WORK
PERMIT
OWNER e
r ,- &_
/
�C� r cdC/e-ir
PHONE (Daytime Contact):
MAILING ADDRES :
/'-(%2A ,
/
yam- o'So'44.
g9,.? ?
(street)
X
(city/state)
(ZIP)
CONTRACTOR:
t.
FUEL BURNING APPLIANCE
LICENSE C:
MAILING ADDRESS:
519
-
PHONE #:
Q� / ^ 70 7
UNLISTED APPLIANCE (ADDITIONAL FEE)
= OR <400,000
(street)
X
(city/state)
(ZIP)
METHOD OF PA
❑ CASH 0 CHECK
DATE:
BANKCARD NUMBER
AUTHORIZED SIGNATURE:
EXPIRES:
5c -f1
DESCRIPTION OF WORK
5 OF UNITS
X
COST
EQUALS
AMOUNT
1
FUEL BURNING APPLIANCE
- OR < 100,000
X
515
-
2
FUEL BURNING APPLIANCE
> 100,000
X
519
-
3
UNLISTED APPLIANCE (ADDITIONAL 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
539
-
10
BOILER/REFRIGERATION
1001 - 1,750M BTU
X ,
557
-
11
BOILER/REFRIGERATION
+1750M BTU
X
595
-
12
GAS LOG, GAS INSERT, GAS FIREPLACE
-
X
510
-
13
RANGE
-
X
510
-
14
DRYER
-
X
510
-
15
FUEL BURNING WATER HEATER
-
X
510
-
16
MISC. FUEL BURNING APDL.
-
X
510
-
17
GAS PIPING (ea. Outlet)
-
X
51
a? CO
1B
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
Alit CONDITIONER
3-15 TON
X
520
-
27
AIR CONDITIONER
15.30 TON
X
525
-
28
AIR CONDITIONER
30-50 TON
X
535
=
29
AIR CONDMONER
+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
=
MENTPLUS
ISA'
rN s,
SUBTOTAL:
PROCESSING FEE:
$35,00
TOTAL PERMIT FEE DUE: 37 ,Qf
❑ CASH 0 CHECK
DATE:
BANKCARD NUMBER
AUTHORIZED SIGNATURE:
EXPIRES:
5c -f1