2003, 09-17 Permit App: BLD-03-02496 Stove, Pipingarrcx 00 .,
Spokane
. 001/alley
Mechanical Permit Application
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
509-688-0037 - Fax
Spokane Valley, WA 99206
PR
. /c.::)(1 ` , (�T
ADDRESS: J / (7-��//y,I
PERMIT
USE:
OWNER: V / ,n,
PHONE (Daytime Contact): 19/,.._ O,Q�y
MAILING ADDRESS l��
/314 s- (76---,C/alley__
(street) /state
( t3' ) (ZIP)
CONTRACTOR: , p 5 C c
LICENSE #:
MAILING ADDRESS:
PHONE #:
ci (,:,2_,,,,R5 „f,-4gi,,)p au -e sp*,,,,,, 044- qe,rzcsi
(street) (city/state) (ZIP)
DESCRIPTION OF WORK
# OF UMTS
X
COST
EQUALS
AMOUNT
1
FUEL BURNING APPLIANCE
- OR < 100,000
X
515
-
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 5100
=
7 BOILER/REFRIGERATION 1 - 100M BTU
8 BOILER/RP:Mr:PR n grin: _. - _—_
X 515 -
9
10
11
BOILER/REFRIGERATION
BOILER/REFRIGERATION
501 - 1,000M BTU
X
528
$39
BOILER/REFRIGERATION
1001 - 1,750M BTU
X
557
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
GAS LOG, GAS INSERT, GAS FIREPLACE
RANGE
+1750M BTU
X
$95
X
510
DRYER
X
510
FUEL BURNING WATER HEATER
X
510
MISC FUEL BURNING ADPL.
GAS PIPING (ea. Outlet)
X
$10
X
$10
DUCT SYSTEMS
X
51
VENTILATING FANS
X
510
AIR HANDLER (DOES NOT include ducting)
AIR HANDLER (DOES NOT include ducting)
EVAPORATIVE COOLERS
X
510
- OR < 10,000CFM
X
512
> 10,000 CFM
X
519
TYPE I HOOD
TYPE II HOOD
HEAT PUMP/AIR CONDITIONER
AIR CONDITIONER
0-3 TON
X
X
X
X
510
550
510
512
3-15 TON
AIR CONDITIONER
15-30 TON
AIR CONDITIONER
30-50 TON
AIR CONDITIONER
LPG STORAGE TANK
+50 TON
X
X
X
X
$20
525
535
560
WOOD OR PELLET STOVE/INSERT
X
510
WOOD STOVE - FREE STANDING
X
X
510
525
METHOD OF PAYMENT
11111111111111
0 CASHVISA
0 CHECK 0
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
SUBTOTAL:
PLUS PROCESSING FEE:
$35.00
TOTAL PERMIT FEE DUE: