2003, 11-17 Permit App: BLD-03-03092 Gas PipingOT1't>r
Spokane
,,,.•Walley
Mechanical Permit Application
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206
509-688-0037 - Fax
PROJECT
ADDRESS: (70it N 1V u r5 ;.it r. ie,
PERMIT
USE:
OWNER:
✓ f) , i /7 y, l t ,` '..
PHONE (Daytime Contact): J 4t '16 . y
MAILING ADDRESS:
Pa c'i
r3//
.5'
L., w�
y‘/- 2,z
(street)
" - OR < 100,000
(city/state)
(ZIP)
CONTRACTOR:
2
FUEL BURNING APPLIANCE
LICENSE #:
MAILING ADDRESS: -•
.
-
PHONE #:
UNLISTED APPLIANCE (ADDITIONAL FEE)
- OR <400,000
(street)
$50
-
(city/state)
(ZIP)
UNLISTED APPLIANCE (ADDITIONAL FEE)
> 400,000
X
$100
METHOD OF PA
❑ CASH 0
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
8 OF UNITS
X
COST
EQUALS
AMOUNT
1
FUEL BURNING APPLIANCE
" - OR < 100,000
X
' $15
-
2
FUEL BURNING APPLIANCE
> 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/REFRIGERAT1ON
I - 160M 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 BTU
X
$95
-
12
GAS LOG, 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 APPL.
-
X
$10
-
17
GAS PIPING (ea. Outlet)
-
it
X
$1
-
a, OD
18
DUCT SYSTEMS
-
X
$10
-
v
19
VENTILATING FANS
-
X
$10
-
20
AIR HANDLER (DOES NOT indude 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
-
32
WOOD STOVE - FREE STANDING
-
X
$25
-
6IENT
iiiiiiii VISA i wsf {.
'rry ri r -t :,•
SUBTOTAL:
2 400
PLUS PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE ` 37C
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: