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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: