2005, 09-21 Permit App: 05003474 Furnace, Water HeaterSgoka`
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il
Project Address:
Owner.
Mailing Address:
Contractor.
MECHANICAL PERMIT APPLICATION .3471 4
Phone: (509) 688-0036; FAX: (509) 688-0037
For Inspections, Call (509) 688-0054
51 -
Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
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35, 11 r OPsrne k,, Spa 1/,,11.) 99216 Permit Use: FL/grate s W A'TS" j4BnTf42- (ijA& fO✓Tl-
• ill / liar n / , i n I ' P Phone (Daytime Contact): 2 - 'I C
Mailing Address.
13c/P E 1eSrHrtr
D J precis -len
1Zgla N 14an+iHon
License #:
pokani VA)jev w4 9921
city State Zip Code
D PREJR97ILt9 Phone#: '-I67-6700
SPvkArle wA g920$
Ciry State Zip Code
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
/
X
112.00
=
I 7.-
2
2
FUEL BURNING APPLIANCE
More than 100,000 -
X .
115.00
3
UNLISTED APPLIANCE (Additional Fee)
Equal to or less than 400,000
X
550.00
=
4
UNLISTED APPLIANCE (Additional Fee)
More than 400,000
X
1100.00
=
5
USED APPLIANCE (WSEC min. AFUE rating)
Equal to or less than 400.000
X
150.00
=
6
USED APPLIANCE (WSEC min. AFUE rating)
More than 400,000
X
1100.00
=
7
BOILER/REFRIGERATION
1 - 100M BTU
X
112.00
=
8
BOILER/REFRIGERATION
101 - 500M BTU
X
120.00
=
9
BOILER/REFRIGERATION
501 - 1,000M BTU
X
125.00
=
10
BOILER/REFRIGERATION
1,001 -1,75014 BTU
X
135.00
=
11
BOILEPJREFRIGERATION
More than 1,750M BTU
X
160.00
=
12
GAS LOG, GAS INSERT. GAS FIREPLACE
X
110.00
=
13
RANGE
X
110.00
=
14
DRYER
X
110.00
=
15
FUEL BURNING WATER HEATER
/
X
S10.00
=
1 0
16
MISC. FUEL BURNING APPLIANCE
X
110.00
17
GAS PIPING (each outlet)-
X
11.00
=
16
DUCT SYSTEMS
X
110.00
=
19
VENTILATING FANS
X
110.00
=
20
AIR HANDLER (DOES NOT include ducting)
Equal to or less than 10,000 CFM
X
$12.00
=
21
AIR HANDLER (DOES NOT include ducting)
Greater than 10,000 CFM
X
115.00
_
22
EVAPORATIVE COOLERS
X
110.00
=
23
TYPE I HOOD
X
150.00
=
24
TYPE II HOOD
-
X
$10.00
=
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
X
112.00
=
26
AIR CONDrONER
3-15 TON
X
120.00
=
27
AIR CONDITIONER -
15-30 TON
X
525.00
=
28
AIR CONDITIONER
- 30-50 TON'
X
135.00
=
29
AIR CONDITIONER
More than 50 TON
X
160.00
=
30
LPG STORAGE TANK
X
$10.00
=
31
WOOD OR PELLET STOVE/INSERT
X
110.00
=
32
WOOD STOVE - FREE STANDING
X
$25.00
=
33
REPAIR & ADDITIONS
X
115.00
=
34
VENTILATION SYSTEMS -
X.
112.00 '
35
VENTILATION MECHANICAL EXHAUST
X
112.00
=
36
INCINERATOR - RESIDENCE
X
119.00
=
37
INCINERATOR - COMMERCIAL
X
122.00
=
METHOD OF PAYMENT:
❑ CASH 0 CHECK 0 VISA ❑ MC
CARD
SUBTOTAL
DATE:
PROCESSING FEE
135.00
EXPIRES:
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE: