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: