2005, 04-01 Permit App: 05001048 Gas Pipingne
A*
Project Address: _
Owner. i�nb0
MECHANICAL PERMIT APPLICATION
Phone: (509) 688-0036; FAX: (509) 688-0037
For Inspections, Call (509) 688-0054
`l.o3 E 7'Ylaih AL'e-
tA- vow SLS
Mailing Address: S
SpoK
Permit Use:
Community Development Departmen
Building Divisioi
11707 E. Sprague Avenue, Suite 101
Spokane Wiley, WA 99201
Phone (Daytime Contact): S'09 -8o -SI) o
'- w • 99a la
City
C6y State Lp Code
Phone #:
Contractor. License #:
Mailing Address:
c
tate
ZrP Cede
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK -
tF OF UNITS
X
DOST
=
TOTAL AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100.000
X
- St2.00
=
2
FUEL BURNING APPLIANCE
More than 100,000
X
515 DO .
=
3
UNLISTEDAPPLIANCE (Additional Fee)
Equal to or less than 400,000
X
550.00
=
4
UNLISTED APPLIANCE (Additional Fee)
More than 400,000
X
5100.00
=
5
USED APPLIANCE (WSEC min. AFUE rating)
Equal to or less than 400,000
_
X
550.00
=
6
USED APPLIANCE (WSEC min. AFUE rating)
More than 400,000
X
5100.00
=
7
BOILER/REFRIGERATION
1: 100M BTU
X
512.00
=
6
BOILER/REFRIGERATION
101 - 500M BTU
X
520.00
=
9
BOILER/REFRIGERATION
501 -1.000M BTU
X
525.00
=
10
BOILER/REFRIGERATION
1 001 - 1,750M BTU
X
535 00
=
11
BOILER/REFRIGERATION
More than 1.750M BTU
X
560 00
=
12
GAS LOG. GAS INSERT, GAS FIREPLACE
X
510 00
=
13
RANGE
X
51000
=
14
DRYER
X
510.00
=
15
FUEL BURNING WATER HEATER
X
510.00
=
16
MISC. FUEL BURNING APPLIANCE
X
51000
=
17
GAS PIPING (each outlet)
1
X
51.00
=
18
DUCT SYSTEMS
X
510 00
=
19
VENTILATING FANS
X
510.00
=
20
AIR HANDLER (DOES NOT include ducting)
Equal to or less than 10.000 CFM .
X
512.00
=
,
21
AIR HANDLER (DOES NOT include ducting)
Greater than 10,000 CFM
X
515.00
=
22
EVAPORATIVE COOLERS
X
51000 -
_
23
TYPE I HOOD
X
550.00
=
24
TYPE II HOOD
X
510.00
=
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
X
. $12.00
=
26
.AIRCONDrTJONER
3-15 TON
X
520.00 --
._
27
AIR CONDITIONER
15-30 TON
X
225.00
=
28
AIR CONDITIONER
30-50 TON
X
535.00
=
29
AIR CONDITIONER -
More than 50 TON
X
560.00
=
30
LPG STORAGE TANK
X
510.00
=
31
WOOD 0R PELLET STOVE/INSERT .
X
510.00
=
32
WOOD STOVE - FREE STANDING
X
525.00
=
33
REPAIR & ADDITIONS
X
515.00
=
34
VENTILATION SYSTEMS
X
' 512.00
=
35
VENTILATION MECHANICAL EXHAUST
X
512.00
=
36
INCINERATOR - RESIDENCE ?
X
519.00 '
=
37
INCINERATOR - COMMERCIAL
X
522.00
METHOD OF PAYMENT:
0 CASH 0 CHECK (A VISA 0 MC
CARD II:
DATE:
SUBTOTAL
PROCESSING FEE
535.00
EXPIRES:
TOTAL PERMIT FEE DUE:
X1
, - y n . �
AUTHORIZED SIGNATURE: