2004, 01-12 Permit App: BLD-04-03395 FurnaceSpokane
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 /1 q/ 7 ! yy/a /�
ADDRESS: / !� /'r
PERMIT
USE:
OWNER /9 liceei
' Ac.-
JvA'
PHONE (Daytime Contact):
MAILING ADDRESS.
EQUALS
AMOUNT
1
(street)
• OR < 100,000
(city/state)
(ZIP)
CONTRACTOR: cleylr
'
i
LICENSE 1:
FUEL BURNING APPLIANCE
MAILING ADDRESS:
X
PHONE #:
•
3
(street)
• OR < 400,000
(city/state)
(ZIP)
METHOD OF PA
❑ CASH ❑ C
DATE- EXPIRES.
BANKCARD NUMBER
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
1 OF UNITS
X
COST
EQUALS
AMOUNT
1
FUEL BURNING APPLIANCE
• OR < 100,000
X
515
•
i
2
FUEL BURNING APPLIANCE
> 100,000
X
519
•
3
UNLISTED APPLIANCE (ADDITIONAL FEE)
• OR < 400,000
X
550
•
4
UNLISTED APPLIANCE (ADDITIONAL 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
$28
•
9
BOILER/REFRIGERATION
501- 1,000M BTU
X
$39
•
10
BOILER/REFRIGERATION
1001- 1,750.M BTU
X
557
•
11
BOILER/REFRIGERATION
+1750M BTU
X
595
•
12
GAS LOG, CAS INSERT, CAS FIREPLACE
-
X
510
•
13
RANGE
-
X
510
•
14
DRYER
-
X
$10
-
15
FUEL BURNING WATER HEATER
-
X
510
•
16
MISC FUEL BURNING APPL.
-
X
510
-
17
GAS PIPING (ea Outlet)
-
X
51
•
18
DUCT SYSTEMS
-
- X
510
•
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
EVAPORATNE COOLERS
-
X
510
-
23
TYPE I HOOD
_
X
550
•
24
TYPEI HOOD
-
X
510
•
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
X
512
•
26
AIR CONDMONER
3-15 TON
X
520
-
27
AIR CONDITIONER
15-30 TON
X
$25
•
28
AIRCONDITIONER
30-50 TON
X
535
•
29
AIRCONDVHONER
+50 TON
X
560
•
30
LPC STORAGE TANK
-
X
510
•
31
WOOD OR PELLET STOVE/INSERT
-
X
510
-
32
WOOD STOVE - FREESTANDING
-
X
525
•
HENT
__ __ - —.VISA — r_,�i .
i s �..
SUBTOTAL:
PLUS PROCESSING FEE:
$35.00
TOTAL PERMIT FEE DUE:
DATE- EXPIRES.
BANKCARD NUMBER
AUTHORIZED SIGNATURE: