2004, 02-18 Permit App: BLD-04-03579 Gas Piping*lane
,�,.•� Valley
Mechanical Permit Application
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206 509-688-0037 - Fax
For Inspections, call 509-688-0054
PROJECT
ADDRESS: .5 0 0 4
DESCRIPTION OF WORK
A) L. \, ' J
C.:1 -USE:
X
COST
PERMIT
6S, ?iQ e_
OWNER: ems}
FUEL BURNING APPLIANCE
's • -t 5
X
$15
PHONE (Daytime Contact): 110_ t & S.2_
MAILING ADDRESS:
J 0 o `l
2
N
i—'.
\\ ; c..,J
<LL-
`'I',
(C,.,,.>< L—)A `11'24 L
(street)
3
UNLISTED APPLIANCE (ADDITIONAL FEE)
= OR <400,000
(city/state)
$80
-
(ZIP)
CONTRACTOR:
4.LICENSE
> 400,000
X
$100
=
#:
USED APPLIANCE (WSEC min. AFUE rating)
MAILING ADDRESS:
X
$50
=
6
USED APPLIANCE (WSEC min. AFUE rating)
PHONE #:
X
$100
=
7
(street)
1-100M BTU
X
$15
(city/state)
8
(ZIP)
METHOD OF PA
❑ CASH ❑ C
DATE: 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
$19
-
3
UNLISTED APPLIANCE (ADDITIONAL FEE)
= OR <400,000
X
$80
-
4
UNLISTED APPLIANCE (ADDITIONAL FEE)
> 400,000
X
$100
=
5
USED APPLIANCE (WSEC min. AFUE rating)
= or < 400,000
X
$50
=
6
USED APPLIANCE (WSEC min. AFUE rating)
> 400,000
X
$100
=
7
BOILER/REFRIGERATION
1-100M BTU
X
$15
=
8
BOILER/REFRIGERATION
101- 500M BTU
X
$28
=
9
BOILER/REFRIGERATION
501-1,000M BTU
X
$39
=
10
BOILER/REFRIGERATION
1001-1,750M BTU
X
$57
=
11
BOILER/REFRIGERATION
+1750M BTU
X
$95
=
12
GAS LOG, GAS INSERT, GAS FIREPLACE
-
X
$10
-
13
RANGE
--
X
$10
-
14
DRYER
-
X
$10
-
15
FUEL BURNING WATER HEATER
--
X
$10
=
16
MISC. FUEL BURNING APPL.
-
X
$10
=
17
GAS PIPING (ea. Outlet)
-
X
$1
=
18
DUCT SYSTEMS
-
X
$10
-
19
VENTILATING FANS
-
X
$10
20
AIR HANDLER (DOES NOT include ducting)
= OR < 10,000CFM
X
$12
=
21
AIR HANDLER (DOES NOT include ducting)
> 10,000 CFM
X
$19
=
22
EVAPORATIVE COOLERS
-
X
$10
=
23
TYPE I HOOD
-
X
$50
=
24
TYPE II HOOD
--
X
$10
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
X
$12
=
26
AIR CONDITIONER
3-15 TON
X
$20
-
27
AIR CONDITIONER
15-30 TON
X
$25
-
28
AIR CONDITIONER
30-50 TON
X
$35
=
29
AIR CONDITIONER
+50 TON
X
$60
=
30
LPG STORAGE TANK
-
X
$10
=
31
WOOD OR PELLET STOVE/INSERT
-
X
$10
=
32
WOOD STOVE - FREE STANDING
-
X
$25
=
KENT
yj$q' r'Sc
SUBTOTAL:
PLUS PROCESSING FEE:
43,5,98------..
TOTAL PERMIT FEE DUE:
DATE: EXPIRES:
BANKCARD NUMBER.:
AUTHORIZED SIGNATURE: