2005, 03-21 Permit App: 05000847 Water HeateraTr Mrtrw,
po` ian'.
.0• Valley
Mechanical Permit Application
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley;'WA 9,206
509-688-0037 - Fax
PROJECT
ADDRESS: f1tt
DESCRIPTION OF WORK
# OF UNITS
PERMIT
USE:
OWNER ` 1Wa' 2
.2-- ,j/ /
i`
AMOUNT
i 1 i
PHONE (Daytime Contact): 5 3 -(. tit lily
Y `T
MAILING ADDRESS:
- OR < 100,000
CC
/.fe'l — ---
X
(street)
(street)
-
(city/state)
(ZIP)
CONTRACTOR,
r
j_ r
C
X
LICEN�$r#�SGs 9 �p jj7
O
MAILING ADDRESS:
,61720
.T)ra-
r'
PHONE7t:
_2_,2 66069'
.a-- ..,-,7) �R 1
(street)
550
(city/state)
(ZIP)
METITOD OF PAY
❑ CASH tZ1 C
•
DATE: ' _3 —2 % - EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
# OF UNITS
X
COST
EQUALS
AMOUNT
1
FUEL BURNING APPLIANCE
- OR < 100,000
X
$15
-
2
FUEL BURNING APPLIANCE
> 100,000,
X
519
-
3
UNLISTED APPLIANCE (ADDITIONAL FEE)
- OR <400,000
X
550
-
4
UNLISTED APPLIANCE (ADDITIONAL FEE)
> 400,000 '
X
5100
5
USED APPLIANCE (WSEC min. AFUE rating)
- or < 400,000
' X
S50
-
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 BTU
X
539
10
BOILER/REFRIGERATION
1001-1,750M BTU
X .
557
-
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
-
/a C'C'
16
MISC. FUEL BURNING APPL.
-
X
510
-
17
GAS PIPING (ea. Outlet)
-
X
SI
-
•
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)
> 10,000 CFM
X
519
-
22
EVAPORATIVE COOLERS
-
X
510
-
23
TYPE I HOOD
-
X
S50
-
24
TYPE II HOOD -
-
X.
510
-
25
HEAT PUMP/AIR CONDITIONER •
0-3 TON
X
512
-
26
AIR CONDITIONER
3-15 TON
X
520
-
27
AIR CONDITIONER
15-30 TON
X
525
-
28
AIR CONDITIONER
30-50 TON
X
$35
-
29
AIR CONDITIONER
+50 TON
X
560 '-
30
LPC STORAGE TANK
-
X
510
-
31
WOOD OR PELLET STOVE/INSERT
-
X
510
-
32
WOOD STOVE - FREE STANDING
-
X
525
=
•
TIENT .
i `2bpL�It�C�-
SUBTOTAL:
PLUS PROCESSING FEE:
$35.00
TOTAL PERMIT FEE DUE:
Li S �x.