2004, 08-10 Permit App: BLD-04-07327 Water Heater**me
awn
Mechanical Permit Application
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206
509-688-0037 - Fax
02 -77
PROJECT
ADDRESS: /6 7 /s( / /J
9�
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PERMIT
USE:
X
J(1
OWNER: 4- P /
EQUALS
AMOUNT
PHONE (Daytime Contact):
92 se a 9 7,/
MAILING ADDRESS:
X
$15
r
(street)
(city/state)
FUEL BURNING APPLIANCE
(ZIP)
CONTRACTOR/ %
l (2 J
$19
i
3c,,,
9 g i" r
J A�yv/„
-
MAILING ADDRESS: !/
,, 77O <2
t'
LICE
66;406C/9'
.1) 'I—_
D 0 ''R 1
(street)
(city/state)
(ZIP)
$100
METHOD OF PA
0 CASH KC
DATE: t %O - 0 EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
# OF UNITS
X
COST
EQUALS
AMOUNT
1
FUEL BURNING APPLIANCE
- OR < 100,000
X
$15
2
FUEL BURNING APPLIANCE
> 100,000,
X
$19
-
3
UNLISTED APPLIANt:E (ADDITIONAL FEE)
= OR < 400,000
X
$50
-
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
$100
-
7
BOILER/REFRIGERATION
1 - 100M BTU
X
$15
-
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
$10
=
14
DRYER
-
X
$10
-
15
FUEL BURNING WATER HEATER
-
X
810
=
/0e 6'4'
16
MISC FUEL BURNING APPL.
-
X
$10
-
17
GAS PIPING (ea. Outlet)
--
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
$10
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
$25
-
28
AIR CONDITIONER
30-50 TON
X
$35
-
29
AIR CONDrFIONER
+50 TON
X
$60
-
30
LPG STORAGE TANK
--
X
$10
-
31
WOOD OR PELLET STOVE/INSERT
-
X
810
=
32
WOOD STOVE -FREE STANDING
-
X
825
-
KED
. , '?.sE „ i
SUBTOTAL:
/D, 00
PLUS PROCESSING FEE:
$35.00
TOTAL PERMIT FEE DUE:
DATE: t %O - 0 EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: