2003, 11-07 Permit App: BLD-03-03026 Pellet StoveS"o.ne
,,000 Valley
Mechanical Permit Application
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206
509-688-0037 - Fax
PROJECT
ADDRESS: S
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PERMIT
USE: `
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COST
OWNER: 0 !
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FUEL BURNING APPLIANCE
PHONE (Daytime Contact):
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MAILING ADDRESS:
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r17,3rz r
ki -
/ 6,-2 i/1/1G1
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, 7
(street)
X
$19
(city/state)
'!
(ZIP)
UNLISTED APPLIANCE (ADDITIONAL FEE)
- OR <400,000
CONTRACTOR
r
$50
-
LICENSE #:
UNLISTED APPLIANCE (ADDITIONAL FEE)
> 400,000
MAILING ADDRESS: •
•
- .
-
•
5
PHONE #:
- or <400,000
X
• $50
-
6
(street)
> 400,000
(city/state)
$100
(ZIP)
7
METHOD OF PA
❑ CASH 0
❑
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
# OF UNITS
X
COST
EQUALS
AMOUNT
1
FUEL BURNING APPLIANCE
- OR < 100,000
X
' $15
-
2
FUEL BURNING APPLIANCE r
> 100,000
X
$19
-
3
UNLISTED APPLIANCE (ADDITIONAL FEE)
- OR <400,000
X
$50
-
4
UNLISTED APPLIANCE (ADDITIONAL FEE)
> 400,000
X
$100
-
5
USED APPLIANCE (WSEC min. AFUE rating)
- or <400,000
X
• $50
-
6
USED APPLIANCE (WSEC min. AFUE rating)
> 400,000
X
$100
-
7
BOILER/REFRIGERATION
1 - 100M BTU
X
$15
8
BOILER/REFRIGERATION
101- 500M BTU
X
$28
-
9
BOILER/REFRIGERATION
501-1,000M BTU
X
$39
-
10
BOILER/REFRIGERATION
1001-1,750M BTU
X
$57
-
11
BOILER/REFRIGERATION
+1750M 811J
X
$95
-
12
GASLOG, GAS INSERT, GAS FIREPLACE
-
X
$10
-
13
RANGE
-
X
$10
-
14
DRYER
-
X
$10
-
15
FUEL BURNING WATER HEATER
-
X
$10
-
16
MISC FUEL BURNING AP_PL.
---
X_ _--
--.$.10
_--_
17
GAS PIPING (ea. Outlet)
-
X
$1
-
18
DUCT SYSTEMS
-
X
$10
-
19
VENTILATING FANS
-
X
$10
-
20
AIR HANDLER (DOES NOT include ducting)
- OR < 10,000CFM
X
$12
-
21
AIR HANDLER (DOES NOT include ducting)
> 10,000 CFM
X
$19
-
22
EVAPORATIVE COOLERS
-
X
$10
-
23
TYPE I HOOD
-
X
$50
.
24
TYPE II HOOD
-
X
$10
-
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
X
$12
.
26
AIR CONDITIONER
3-15 TON
X
$20
-
27
AIR CONDITIONER
15-30 TON
X
$25 - .
-
28
AIR CONDITIONER
30-50 TON
X
$35
-
29
AIR CONDITIONER
+50 TON
X
$60
-
30
LPG STORAGE TANK
-
X
..$10
31
WOOD OR PELLET STOVE/INSERT
-
X
- $10
i
32
WOOD STOVE - FREE STANDING
-
X
$25
-
1ENT
MM.VISA ' SP F
irrry P-1 r --
SUBTOTAL:
t o 0 O
PLUS PROCESSING FEE:
$35.00
TOTAL PERMIT FEE DUE: `L - 0 ]�
v
❑
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: