2004, 09-27 Permit App: BLD-04-07769 Range, PipingMECHANICAL PERMIT APPLICATION
PROJECT---
7 .( L ---7,-, *
ADDRESS: 62 L -
PERMIT
USE:
OWNER:PHONE
/7C.y IA-(
(Daytime Contact):
MAILING ADErESS:
7 7 2 c - : ' • • Spc4„,c OA co Z I 2_
-e -(Street)
'
Y (City/State) (Zip)
CONTRACTOR:
LICENSE:
MAILING ADDRESS:
PHONE:
(Street) (CiLy/State)
(Zip)
DESCRIPTION OF WORK
# OF
UNITS
MULTI-
PLJED
By
COST/
UNIT
EQUALS
AMOUNT
FUEL BURNING APPLIANCE
= OR <100,.000
X
$12
=
$
FUEL BURNING APPLIANCE
>100,000
X
$15
=
UNLISTED APPLIANCE (ADDITIONAL CHARGE)
= OR <400,.000
X
$50
=
$
UNLISTED APPLIANCE (ADDITIONAL CHARGE)
>400,000
X
$100
=
USED APPLIANCE (Must meet WSEC's min. AFUE rating)
= OR <400,.000
X
$50
=
USED APPLIANCE (Must meet WSEC's min. AFUE rating)
>400,000
X
$100
=
BOILER/REFRIGERATION
1-100M BTU
X
$12
=
BOILER/REFRIGERATION
101-500M BTU
X
$20
=
BOILER/REFRIGERATION
501-1,000M BTU
X
$25
=
$
BOILER/REFRIGERATION
1,001- 1,750M BTU
X
$35
=
$
BOILER/REFRIGERATION
+1,750M BTU
X
$60
=
$
GAS LOG, GAS INSERT, AND/OR GAS FIREPLACE
-
X
$10
=
$
RANGE-
f
-
I
X
$10
=
$
DRYER
-
X
$10
=
$
FUEL BURNING WATER HEATER
-
X
$10
=
$
MISCELLANEOUS FUR BURNING APPLIANCE
-
X
$10
=
$
GAS PIPING (ea. Outlet)
-
X
$1
=
$
DUCT SYSTEMS
-
X
$10
=
VENTILATING FANS
-
X
$10
=
AIR HANDLER (DOES NOT include duct systems)
= OR <10,000 CFM
X
$12
=
AIR HANDLER (DOES NOT include duct systems)
>10,000 CFM
X
$15
=
$
EVAPORATIVE COOLERS
-
X
$10
=
$
TYPE I HOOD
-
X
$50
=
$
TYPE II HOOD
-
X
$10
=
HEAT PUMP/AIR CONDITIONER
0-3 TONS
X
$12
=
$
AIR CONDITIONER
3-15 TONS
X
$20
=
$
AIR CONDITIONER
15-30 TONS
X
$25
=
$
AIR CONDITIONER
30-50 TONS
X
$35
=
$
AIR CONDITIONER
+50 TONS
X
$60
=
$
LPG STORAGE TANK
-
X
$10
=
$
WOOD OR PELLET STOVE/INSERT
-
X
$25
=
$
METHOD OF PAYMENT
SUBTOTAL
0 CASH 0 CHECK 0 VISA 0 MASTERCARD 0 DISCOVER
PLUS: PROCESSING FEE
$ 25.00
FAXED PERMITS WILL ONLY BE ACCEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
SUBTOTAL: MINIMUM PERMIT FEE
IS $35.00
DATE: EXPIRES:
BANKCARD NUMBER:
PLUS: 16% REGIONAL PLANNING
SURCHARGE
AUTHORIZED SIGNATURE:
TOTAL PERMIT FEE DUE
_
Spokane County Department of u ding and Planning
1026 West Broadway Avenue * Spokane, WA 99260-0050
Telephone No. (509) 477-3675 * Fax No. 477-7198 * TDD No. (509) 477-7133