2004, 01-06 Permit App: BLD-04-03372 Gas Log, Piping3PO ane
..;0OValley
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane Vlley, WA 99206 509-688-0037 - Fax
For Inspections, call 509-688-0054
Mechanical Permit -Application
PROJECT
ADDRESS:/ Z (0 ( 5
GL /VT(99— -Dg--
.9'9 Z/ Z
PERMIT
USE:
OWNER: EL7 WA %Z �;
�A�L C.
PHONE (Daytime Contact):
MAILING ADDRESS:
12 � G .Sr '--e tV11-12 VA- Sc? iC �% V--4C(C y 6772-12
(street)
(city/state)
(ZIP)
CONTRACTOR:
> 100,000
LICENSE #:
MAILING ADDRESS: ``
PHONE #:
(street)
(city/state)
(ZIP)
METHOD OF PA
YT
DESCRIPTION OF WORK
YMENT
>< OF UNITS X
COST EQUALS
AMOUNT
1 FUEL BURNING APPLIANCE
= OR < 100,000
X
$15 =
2 FUEL BURNING APPLIANCE
> 100,000
X
$19
3 UNLISTED APPLIANCE (ADDITIONAL FEE)
= OR <400,000
x
$50 =
4 UNLISTED APPLIANCE (ADDITIONAL FEE)
> 400,000
X
$100 =
5 USED APPLIANCE (WSEC min. AFUE rating)
: or < 400,000
X
$50 =
6 USED APPLIANCE (WSEC min. AFUE rating)
> 400,000
X
$100 =
7 BOILER/REFRIGERATION
1 - loom BN
X
$15 =
8 BOILER/REFRIGERATION
101- 500M BTU
X
$28 =
9 BOILER/REFRIGERATION
501-1,000M BTU
X
$39 =
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
Q
13 RANGE
—
X
$10 =
14 DRYER
_
X
$10 =
15 FUEL BURNING WATER HEATER
--x
$10 =
16 MISC. FUEL BURNING APPL.
—
X
$10 =
17 GAS PIPING (ea. Outlet)
—
X
$1 =
1,00
18 DUCT SYSTEMS
—
X
$10 =
19 VENTILATING FANS
—
X
$10 =
20 AIR HANDLER (DOES NOT include ducting)
- OR < 10,000CFM
x
$12 =
21 AIR HANDLER (DOES NOT include ducting)
> 10,000 CFM
X
$19 =
22 EVAPORATIVE COOLERS
—
X
$10
23 TYPE I HOOD
_
x
$50 =
24 TYPE II HOOD
—
x
$10 =
25 HEAT PUMP/AIR CONDITIONER
0-3 TON
x
$12 =
26 AIR CONDITIONER
3-15 TON
X
$20 =
27 AIR CONDITIONER
15-30 TON
X
$25 =
28 AIR CONDITIONER
30-50 TON
X
$35 =
29 AIR CONDITIONER
+50 TON
X
$60 =
30 LPG STORAGE TANK
—
X
$10 =
31 WOOD OR PELLETSCOVE/INSERT
—
X
$10 =
32 WOOD STOVE - FREE STANDING
—
X
$25 =
VIS4 w.. �,,r. ,, -
away
SUBTOTAL:
PLUS PROCESSING FEE:
TOTAL PERMIT FEE DUE:
/ Q
$35.00
U;S . C-
[I CHECK
DATE:
BANKCARD NUMBER--
AUTHORIZED SIGNATURE:
EXPIRES: