Permit: BD03-059 Mechanical Fixtures�*Ohne
Va11ey
Mechanical Permit Application
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206
509-688-0037 - Fax
D03 -d5°(
PROJECT_ /
ADDRESS: 5 03 N, Loc69 T
PERMIT
USE:
OWNER STfvf B/ /9 P y
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PHONE (Daytime Contact): 9'2,2 -S 0C9O �.,�4/�
MAILING ADDRESS:
'50 3 A) Zor x5[7- 5 P 10 9 9020 6
(street) (city/state) (ZIP)
CONTRACTOR:The, I�� J go C
J� a /
LICENSE #B /9 fTe )p 9 $-o A- 4,
MAILING ADDRESS:
/Piot E/1/o;JT6o1ri y P4 vc #3
5A Ow i&
PHONE #:
/2? S 00
99,20 h
(street) (city/state) (ZIP)
METHOD OF PA
❑ CASH D c
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
o OF UNITS
X
COST
EQUALS
AMOUNT
1
FUEL BURNING APPLIANCE
• OR <140,000
X
515
•
2
FUEL BURNING APPLIANCE
> 100,030
X
519
•
3
UNLISTED APPLIANCE (ADDITIONAL FEE)
• OR c 400,000
X
550
•
4
UNLISTED APPLIANCE(ADDMONAL 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
515
•
8
BOILER/REFRIGERATION
101- 500M BTU
X
528
•
9
BOILER/REFRIGERATION
501 - 1,003M BTU
X
539
•
10
BOILER/REFRIGERAT1ON
1001 - 1750M BTU
X
557
11
BOILER/REFRIGERATION
+1750M BTU
X
595
•
12
GAS LOO, CAS INSERT, CAS FIREPLACE
-
X
510
•
13
RANGE
-
X
510
-
14
DRYER
-
Y
X
510
-
/01°°
15
FUEL BURNING WATER HEATER
-
X
510
•
/1°' 0- m
16
MISC FUEL BURNING APPL.
-
X
510
•
17
GAS PIPING (ea. Outlet)
-
�%
P�
X
51
•
g Od
18
DUCT SYSTEMS
-
X
510
•A
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
550
•
24
TYPE II HOOD
-
X
510
•
25
HEAT PUMP/AIR CONDIEIONER
03 TON
X
512
•
26
AIRCONDITIONER
3.15 TON
X
520
•
27
AIRCONDTTIONER
15-30 TON
X
525
•
28
AIRCONDMONER
30-50 TON
X
535
•
29
AIRCONDTfIONER
+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
•
HENT
visa v_,
— — ♦
SUBTOTAL:
</n Op
PLUS PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE: 5-9 0 0
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: