2004, 07-16 Permit App: BLD-04-07088 Mechanical FixturesMECHANICAL PERMIT APPLICATION
PROJECT ^� p
ADDRESS: L Li I S Al L L 17- O ETff .1 "
PERMIT
USE:
OWNER:-p60PHONE
L 2 IV)�nl5a�
(Daytime Contact):
(-a`/ 1 9Z2.-L/I7Z
MAILING AD S ESSAY Eu z y. $ C Tj-/ S.5 -96/4410E / L1/4-3 4 . 1 r/ Z-/ 2.
H
(Street) (Ci /State) (Zip)
CONTRACTOR. /c LLL Heltll� G-
LICENSE:
MAILING ADDRESS.
PHONE:
(Street) (C
ty/State) (Zip)
DESCRIPTION OF WORK
# OF
UNITS
MULTI-
PeyD
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 FIREPLACE
-
X
$10
=
$
RANGE
-
X
$10
=
$
DRYER
-
X
$10
=
$
FUEL BURNING WATER HEATER
-
X
$10
=
$
MISCELLANEOUS FUEL BURNING APPLIANCE •
-
X
$10
=
$
GAS PIPING (ea. Outlet)
-
I
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
I
1
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
ASH
[24LyASH ❑ CHECK ❑ VISA ❑ MASTERCARD ❑ DISCOVER
PLUS: PROCESSING FEE
$
FAXED PERMITS WILL ONLY BE ACCEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
SUBTOTAL: MINIMUM PERMIT FEE
IS $35.00
DATE: EXPIRES:
PLUS: 16% REGIONAL PLANNING
BANKCARD NUMBER:
SURCHARGE
AUTHORIZED SIGNATURE:
TOTAL PERMIT FEE DUE
LY
/�
Spokane County Department of Building and Planning
1026 West Broadway Avenue Spokane, WA 99260-0050
Telephone No. (509) 477-3675 * Fax No. 477-7198 TDD No. (509) 477-7133