2005, 10-13 Permit App: 05003817 Gas Insert, PipingPermit Center
Spokane 11707 E Spragee Ave, Suite 106
40000\alley Spolame Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
Community Development www.spokanevalley.org.corn
Mechanical Permit Application o Commercial
Residential
SITE ADDRESS I 0 Z C-- • Cie
Building owner
Name: L e C. / e s7 -e_ Phone: 970 - / I 7 0 Fax
Address: g ) 0 Z E - 6 a 4c 6- City cpok Jar(at State W 1 Zip 9q,„/"1.
Contractors _ .. .
Name: ANO E /LS` -S . SN=C 7` C ' 1 er,51 . Phone: C%Z e-' 0 7 (! 0 Fax: 9Z?- 3//f
Address: f 3 90 3 C ri'L.cr.t T 4v C City set In t State GiP Zip 99Z/ c
License No: 19,110 G QS'rn / z; enr 'Z- City Business License No:
Contact.
Name: 47-tQ (G /9 NO r, 5i* re, Phone: Phone:
'"r CF76 0
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or Tess than 100,000
X
$12.00
=
2
FUEL BURNING APPLIANCE
- -More than 100,000
X
$15.00
=
3
UNLISTED APPLIANCE (Additional Fee)
Equal to or less than 400,000
X
$50.00
=
4
UNLISTED APPLIANCE (Additional Fee)
More than 400,000
X
$100.00
=
5
USED APPLIANCE (WSEC min. AFUE rating)
Equal to or less than 400,000
X
$50.00
=
6
USED APPLIANCE (WSEC min. AFUE rating)
More than 400,000
X
$100.00
=
7
BOILER/REFRIGERATION
1 - 100M BTU
X
$12.00
=
8
BOILER/REFRIGERATION
101 - 500M BTU
X
$20.00
=
9
BOILER/REFRIGERATION
501 - 1,000M BTU
X
$25.00
=
10
BOILER/REFRIGERATION
1,001 - 1,750M BTU
X
$35.00
=
11
BOILER/REFRIGERATION
More than 1,750M BTU
X
$60.00
=
12
GAS LOG, GAS INSERT, GAS FIREPLACE
/
X
$10.00
=
/0,00
13
RANGE
X
$10.00
=
14
DRYER
X
$10.00
=
15
FUEL BURNING WATER HEATER
X
$10.00
=
16
MISC. FUEL BURNING APPLIANCE
X
$10.00
=
17
GAS PIPING (each outlet)
/
X
$1.00
=
/ i 00
18
DUCT SYSTEMS
X
$10.00
=
19
VENTILATING FANS
X
$10.00
=
20
AIR HANDLER (DOES NOT include ducting)
Equal to or Tess than 10,000 CFM
X
$12.00
=
21
AIR HANDLER (DOES NOT include ducting)
Greater than 10,000 CFM
X
$15.00
=
22
EVAPORATIVE COOLERS
X
$10.00
=
23
TYPE 1 HOOD
X
$50.00
=
24
TYPE 11 HOOD
X
$10.00
=
25
HEAT PUMP/AIR CONDITIONER ..-
0-3 TON
X
$12.00
=
26
AIR CONDITIONER
3-15 TON
X
$20.00
=
27
AIR CONDITIONER
15-30 TON
X
$25.00
=
28
AIR CONDITIONER
30-50 TON
X
$35.00
=
29
AIR CONDITIONER
More than 50 TON
X
$60.00
=
30
LPG STORAGE TANK
X
$10.00
=
31
WOOD OR PELLET STOVE/INSERT
X
$10.00
=
32
WOOD STOVE - FREE STANDING
X
$25.00
=
33
REPAIR & ADDITIONS
X
$15.00
=
34
VENTILATION SYSTEMS
X
$12.00
=
35
VENTILATION MECHANICAL EXHAUST
X
$12.00
=
36
INCINERATOR - RESIDENCE
X
$19.00
=
37
INCINERATOR - COMMERCIAL
X
$22.00
=
METHOD OF PAYMENT:
DCASH ClCHECK 1:1VISA 1:1MC
CARD #:
SUBTOTAL
/t 0 0
DATE:
PROCESSING FEE
_
$35.00
EXPIRES.
TOTAL PERMIT FEE DUE:
' yti,(k1
AUTHORIZED SIGNATURE:
REVISED 8/26/05