2003, 09-24 Permit App: BLD-03-02572 Mechanical FixturesS°pokan
#Valley
Mechanical Permit Application
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206 509-688-0037 - Fax
PROJECT /
ADDRESS:
;ii, -.-1 ` .( ��t SA__
PERMIT
USE:
))
OWNER l/f;'tnhCO-2L( l) IQ p(*)
o
PHONE (Daytime Contact —
c9'9; 7-7�,5
MAILING ADDRESS:
7,-/ t ,n2/.'sG Ey Sae (A/k/' �1I2/ Z
(street)
(city/state) (ZIP)
CONTRACTOR:
-
LICENSE #:
MAILING ADDRESS: -•
PHONE 1:
' 515
(street)
(city/state) (ZIP)
METHOD OF PA
❑CASH El
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
101' UNITS
X
COST
EQUALS
AMOUNT
t
FUEL BURNING APPLIANCE -
-- OR <100003
X
' 515
-
/J
2
FUEL BURNING APPLIANCE
> 100000
. X
519
-
3
UNLISTED APPLIANCE (ADDITIONAL FEE)
• OR<400,000
-
X
550
-
4
UNLISTED APPLIANCE (ADDITIONAL FEE)
> 400,000
X
5100
-
5
USED APPLIANCE (WSEC min. AFUE rating)-
or <400,000
-
X-
i 550
6
USED APPLIANCE (WSEC min. AFUE rating)
> 400,000
X
5100
-
7
BOILER/REFRIGERAT1ON
1 - 100M BTU
X
515 '
•
8
BOILER/REFRIGERAT1ON
101- 500M BTU
X
528
•
9
BOILER/REFRIGERATION
501- L000M BTU
X
539
-
10
BOILER/REFRIGERATION
1001- 1,750M BTU
X
557
-
11
BOILER/REFRIGERATION
4-1750M BTU
X
595
-
12
GAS LOG, GAS INSERT, GAS FIREPLACE
-
X
510
•
13
RANCE
-
X
510
-
-
14
DRYER
-
X
510
•
15
FUEL BURNING WATER HEATER '
_
X
510
-
/C pu
' 16
MSC FUEL BURNING APPL.
-
X
510
17
GAS PIPING (ea. Outlet)
- -
X
51
-
,^ 00
18
DUCT SYSTEMS
-
X
510
•
19
VENTILATING FANS
-
-
X
510
•
20
AIR HANDLER (DOES NOT include 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 IHOOD
-
X
550
-
29
TYPE II HOOD
-
X
510
-
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
X
512
•
26
AIR CONDITIONER
3-15 TON
X
520
•
27
AIRCONDITIONER
15.30 TON
X
525 -
-
28
AIRCONDIUONER
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 -FREESTANDING
-
X
525
-
4ENT
.
-
Itj.,
SUBTOTAL:
yI O.
PLUS PROCESSING FEE:
$35.00
TOTAL PERMIT FEE DUE 6,98NtCO
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: