2004, 06-10 Permit App: BLD-04-04563 ACS it kan e\°°°'
. Valley
Mechanical Permit Application
11707 East Spragite Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206 509-688-0037 - Fax
For Inspections, call 509-688-0054
PROJECT
ADDRESS: 22OL-
N e /72g a
PERMIT
USE:
OWNER i 'I Pte r5_.
S- 1-Y ( e d
PHONE (Daytime Contact):
COST
MAILING ADDRESS:
AMOUNT
(street) (city/state) (ZIP)
FUEL BURNING APPLIANCE
COMRRHEATINGLICENSE
SMITH & COOLING, INCINC•
#:
SMITHHCO8OR8
X
MAILING ADDRESS:
E. 102 NORA SPOKANE
PHONEI: 328-4431 FAX:
328-0749
WA 99207
FUEL BURNING APPLIANCE
(street) (city/state) (ZIP)
METHOD OF PA
❑ CASH ]C
DATE: EXPIRES:
BANKCARD NUMBER
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
1 OF UMTS
X
COST
EQUALS
AMOUNT
1
FUEL BURNING APPLIANCE
•OR<100,000
X
515
-
2
FUEL BURNING APPLIANCE
> 100,000
X
519
-
3
UNLISTED APPLIANCE (ADDn10NAL FEE)
• OR < 400,000
X
550
•
4
UNLISTED APPLIANCE (ADOMONAL FEE)
> 400,000
X
5100
•
5
USED APPLIANCE (WSEC min. JUDE rating)
• or < 400,000
X
550
-
6
USED APPLIANCE (WSEC min. AFUE rating)
> 400,000
X
5100
•
7
BOILER/REFRIGERATION
1 - 100M BTU
X
515
-
8
BOILER/REFRIGERATION
101 - 500M BTU
X
528
-
9
BOILER/REFRIGERATION
501- 1,000M BN
X
539
-
10
BOILER/REFRIGERATION
1001- L750M BTU
X
557
•
11
BOILER/REFRIGERATION
+1750M BTU
X
595
-
12
CA5 LOC, CAS INSERT, GAS FIREPLACE
-
X
510
-
13
RANGE
-
X
510
-
14
DRYER
-
X
510
•
15
FUEL BURNING WATER HEATER
-
X
510
•
16
MISC FUEL BURNING APPL.
-
X
510
-
17
GAS PIPING (ea. Outlet)
-
X
51
-
18
DUCT SYSTEMS
-
X
510
-
19
VENTILATING FANS
-
X
510
-
20
AIR HANDLER (DOES NOT include ducting)
• OR<10,000CFM
X
512
-
21
AIR HANDLER (DOES NOT include ducting)
>10,000CFM
X
519
•
22
EVAPORATIVE COOLERS
-
X
510
•
23
TYPE I HOOD
-
X
550
•
24
TYPE I HOOD
-
- X
510
-
25
HEAT PUMP/AIRCONDITIONER
0-3 TON
1
X
512
•
12-80
26
AIR CONDMONER
3-15 TON
X
520
-
27
AIRCONDmONER
15-30TON
X
525
-
28
AIRCONDrn0NER
3450 TON
X
535
-
29
AIR CONDITIONER
.50 TON
X
560
-
30
LPG STORAGE TANK
-
X
510
-
31
WOOD OR PELLETSTOVE/INSERT
-
X
510
•
32
WOOD STOVE - FREESTANDING
-
X
525
-
VIENT
-�"
SUBTOTAL:
i2,QO
PLUS PROCESSING FEE:
$35.00
TOTAL PERMIT FEE DUE: 4q. Go
DATE: EXPIRES:
BANKCARD NUMBER
AUTHORIZED SIGNATURE: