2004, 01-12 Permit App: BLD-04-03394 Water Heater*octane
,Valley
Mechanical- Permit Application
11707 East Spragt,ze Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206 509-688-0037 - Fax
For Inspections, call 509-688-0054
PROJECT
ADDRESS: E.( Z t I \ L ,Joe -A 0I?
PERMIT
USE:
OWNER L107 S?LAS
X
PHONE (Daytime Contact):(4)ej) 927-n//
h
MAILING ADDRESS:
E (Z\ t 1 LEADORA or .
sp,izc LA 99 2_0 C,
(street)
(city/state)
(ZIP)
CONTRACTOR:
X
LICENSE 1:
-
MAILING ADDRESS:
2
PHONE 1:
> 100,000
X
(street)
(city/state)
(ZIP)
METHOD OF PA
0 CASH
❑ c
DATE: / — / 2 - O 7 EXPIRES:
BANKCARD NUMBER
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
a 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
$50
•
4
UNLISTED APPLIANCE (ADDITIONAL FEE)
> 400,000
X
5100
-
5
USED APPLIANCE (WSEC min AFUE rating)
- or <400,000
X
550
-
6
1.130 El APPLIANCE (WSEC min. AFUE rating)
>400,000
X
$100
-
7
BOILER/REFRIGERATION
I - 100M BTU
X
515
•
8
BOILER/REFRIGERATION
101- 500M BN
X
$28
•
9
BOILER/REFRIGERATION
501- 1,00014 BTU
X
539
-
10
BOILER/REFRIGERATION
1001- 1,750M BN
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
)17.0f)
16
MISC FUEL BURNING APPL.
-
X
510
-
17
GAS PIPING (ea Outlet)
-
X
51
•
18
DUCT SYSTEMS
-
X
$10
•
19
VENTILATING FANS
-
X
510
-
20
AIR HANDLER (DOES NOT includeducting)
• 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/AIRCONDMONER
0-3 TON
X
512
-
26
AIR CONDITIONER
3-15 TON
X
520
-
27
AIRCONDITIONER
15-30 TON
X
525
-
28
AIRCONDITIONER
30-50 TON
X
535
•
29
AIRCONDITIONER
.50 TON
X
560
-
30
LPG STORAGE TANK
-
X
510
•
31
WOOD OR PELLET STOVE/INSERT
-
X
510
•
32
WOOD STOVE - FREESTANDING
-
X
525
-
vIENT
WS _ r...aiiiiiti
SUBTOTAL:
PLUS PROCESSING FEE:
$35.00
TOTAL PERMIT FEE DUE: 473--: 00
DATE: / — / 2 - O 7 EXPIRES:
BANKCARD NUMBER
AUTHORIZED SIGNATURE: