2004, 04-13 Permit App: BLD-04-04069 Stove, PipingMECHANICAL PERMIT APPLICATION ?)c -,5:-R:1:3 ;9
PROJECT
ADDRESS: (.70 •5 ....) , C s 4(4--
PERMIT ;
USE: 5 )1172k__
OWNER: 0,
LaCE9le_ 6 Gp-e,e—,----
PHONE (Daytime Contact):
,-.2--C - // i-
MAILING ADDPESS: -
71 4 av, ,a, rr-13 5 f), i T (--1%vy_Atz t a S cy..5,,,...) 7
1Street) (Ci State) (Zip)
CONTRACTOR, I:
LICENSE:
MAILING ADDRESS:
/V- 6, /17-"'
PHONE:
Ci;s bdo-Jc - , ,..; pi
(Street) (City/State) (Zip)
DESCRIPTION OF WORK
# OF
UNITS
MULTI-
PLIED
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 FIREPLACEt&,
-
X
$10
$ /a o cp
RANGE
-
X
$10
DRYER
-
X
$10
-$
FUEL BURNING WATER HEATER
-
X
$10
MISCELLANEOUS FUEL BURNING APPLIANCE
- .,
X
$10
=
$
GAS PIPING (ea. Outlet)
-
1
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
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 Division of Building & Code Enforcement
1026 West Broadway Avenue • Spokane, WA 99260-0050
Telephone No, (509) 477-3675 • Fax No. 477-7198 TDD No. (509) 477-7133