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2004, 03-24 Permit App: BLD-04-03877 Furnace%lane .0.S Valley Mechanical Permit Application 11707 East,Sprague Avenue, Suite 106 509-688-0036 - Phone Spokane V'alley, WA 99206 509-688-0037 - Fax PROJECTn ADDRESS: I V 60) .» 6fa a (U PERMIT USE: OWNER i ((LinrikLU 'nd a- K► ..5.14Z PHONE (Daytime Contact): ,... 992.3_, )) -33 MAILING ADDRESS: 10)D s E. (0,)ce_ fi-v{- 5 p kon m'/ktj �r,►fr - I9),b( 1 (street) = OR < 100,000 (city/state) (ZIP) X CON�TI�A Oytj_ ��„^1 u \ /.5-.0Z) LICENSE #: )-1--0 v� rT V g 04 MAILING ADDRESS: _ 1)10 i '*,r01‘/V arV kr, p ,, S�, ,Or1E PHONE #: jU l ' &tia'S301 0 W> } (street) UNLISTED APPLIANCE (ADDITIONAL FEE) (city/state) (ZIP) METHOD OF PA ❑ CASH ❑ C ❑ :_..rte DATE: EXPIRES: BANKCARD NUMBER: AUTHORIZED SIGNATURE: DESCRIPTION OF WORK 8 OF UNITS X COST EQUALS AMOUNT 1 FUEL BURNING APPLIANCE = OR < 100,000 / X 515 - /.5-.0Z) 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 5100 - 5 USED APPLIANCE (WSEC min. AFUE rating) - or < 400,000 X 550 - 6 USED APPLIANCE (WSEC min. AFUE rating) > 400,000 X 5100 = 7 BOILER/REFRIGERATION 1-100M BTU X $15 - 8 BOILER/REFRIGERATION 101- 500M BTU X 528 - 9 BOILER/REFRIGERATION 501 - 1,000M BTU X $39 - 10 BOILER/REFRIGERATION 1001 - 1,750M BTU - -X $57 = 11 BOILER/REFRIGERATION +1750M BTU X 595 = 12 GAS LOG, GAS INSERT, GAS FIREPLACE - X 510 - 13 RANGE - X 510 - 14 DRYER - X 510 - 15 FUEL BURNING WATER HEATER - X 510 - 16 MLSC FUEL BURNING APPL - X 510 - l 17 GAS PIPING (ea. Outlet) - 3gir X 51 - .,� g'-`//"� 13 18 DUCT SYSTEMS - X 510 = 19 VENTILATING FANS - X 510 - 20 AIR HANDLER (DOES NOT indude 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 I HOOD - X 550 - 24 TYPE II HOOD - X 510 - 25 HEAT PUMP/AIR CONDITIONER 0-3 TON X 512 - 26 AIR CONDITIONER 3-15 TON X $20 - 27 AIRCONDITIONER 15-30 TON X 525 - 28 AIR CONDI'T'IONER 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 - FREE STANDING - X 525 - TIENT 1011.11111 '� ' SUBTOTAL: PLUS PROCESSING FEE $35.00 TOTAL PERMIT FEE DUE: ❑ :_..rte DATE: EXPIRES: BANKCARD NUMBER: AUTHORIZED SIGNATURE: