2003, 11-14 Permit App: BLD-03-03069 Water HeaterSpokane
,,,*Valley
Mechanical Permit Application
11707 East 8'prague Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206
509-688-0037 - Fax
PROJECT
ADDRESS: ! -roc( St 13 V tit }
PERMIT
USE:
8 OF UNITS
OWNER V e0 u 1 FAcL O f k.9M4-
PHONE (Daytime Contact):
EQUALS
AMOUNT
MAILING ADDRESS:
70y�. /3)
FUEL BURNING APPLIANCE
q� 6
7qC_
J
(street) (city/state)
(ZIP)
-
CONTRACTOR:
LICENSE #:
> 100,000
X
MAILING ADDRESS:..
ZD .-/4-)( r
tom -
PHONE #:
3
UNLISTED APPLIANCE (ADDCI-ZONAL FEE)
- OR <400,000
X
550
=
(street) (city/state)
(ZIP)
UNLISTED APPLIANCE (ADDITIONAL FEE)
> 400,000
METHOD OF PA
0 CASH ld
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
8 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 (ADDCI-ZONAL 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
• 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
$57
-
11
BOILER/REFRIGERATION
+1750M BTU
X
$95
=
12
GAS LOG, GAS INSERT, GAS FIREPLACE
-
X
$10
-
13
RANGE
-
X
$10
-
14
DRYER
-
X
510
=
15
FUEL BURNING WATER HEATER
-
l
X
510
-
/
16
MISC FUEL BURNING APPL. -
-
/
X
110
-
17
GAS PIPING (ea. Outlet)
-
X
51
-
18
DUCT SYSTEMS
-
X
510
-
19
VENTILATING FANS
-
X
510
-
20
AIR HANDLER (DOES NOT indude 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 CONDrrIONER
0-3 TON
X
512
-
26
AIR CONDITIONER
3-15 TON
X
520
-
27
AIR CONDITIONER
15-30 TON
X
525
-
28
AIR CONDITIONER
30-50 TON
X
535
=
29
AIR CONDITIONER
+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
-
'LENT
;t{ai:";
SUBTOTAL:
jQ CXR
/$35.00
PLUS PROCESSING FEE:
TOTAL PERMIT FEE DUE ti
1 .
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: