2003, 10-13 Permit App: BLD-03-02754 Furnace, Piping*ohne'
_,#Valley
'Mechanical Permit Application
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, w) 99206 509-688-0037 - Fax
For Inspections, call 509-688-0054
PROJECT '
ADDRESSI / �D E
A/�(
PERMIT
USE:
L •N-
OWNER Xte-i 'n A-NiLS
1Yt &
COST
PHONE (Daytime Contact): 7 7_/
MAILING ADDRESS:
1
(street)
(city/state) (ZIP)
CONTRACTOR: ) , 7,430LICENSMAILING
X
E #: j-1 AIL / %D} 7,�
S:/D7DjZff, 114/7 o/ESS:PHONE#:
S leo /c-N�, /224
?72/2_
5-0 - 92- 7,7S3
/
FUEL BURNING APPLIANCE
(street)
(city/state) (ZIP)
METHOD OF PA
0 CASH
DATE: - EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTTONOF WORK -
4 OF WJITS
X
COST
EQUALS
AMOUM'
1
FUEL BURNING APPLIANCE
• OR<100,000
X
$15.
•
t 5-, (J7j
2
FUEL BURNING APPLIANCE
> 100,000
X
519
-
3
UNLISTED APPLIANCE (ADDITIONAL FEE)
- OR <400,000
X
550
-
4
UNLISTED APPLIANCE (ADDn1ONAL 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/REFRIGERATTON
101- 500M BTU
-X
528
9
BOILER/REFRIGERATION
501- 1,003M 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 •
-
16
MIST FUEL BURNING APPL.
-
X _
510.
-
17
GAS MING (ea Outlet)
-
X
51
-
/, DZ)
18
DUCT SYSTEMS
_
X
510
19
VENTILATING FANS
-
X
510
- L
20
AIR HANDLER (DOES NOT Include ducting)
• OR<10,000CFM
X
512
-
21
A1R 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 CONDmONER
0-3 TON
X
512
-
26
AIRCONDITIONgR
3-15 TON
X
520
-
27
AIRCONDITIONER
15-30 TON
X
525
-
28
AIRCONDInONER
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 - FREE STANDING
-
X
525
-
KED
- - J j
VISA s
SUBTOTAL:
/6.00
PLUS PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE: �/ f�
7
DATE: - EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: