2003, 07-28 Permit App: BLD-03-02085 Stove1
C^'IpTY c l
Jae
.,,•• ' lley
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane Va11y, I.1!` 99206 509-688-0037 - Fax
For Inspections, call 509-688-0054
Mechanical Permit Application
PROJECT 2 �(,(( PERMIT
ADDRESS: -7 0.(93 e Kae a e 1 ��t ,{
t m tt � �t"l/ USE: S-�-D V�. w. c
OWNER /(n ST Q -t t Ch ttip 1i�vl Pi l
,� ZONE (Daytime Contact): C c27 ^gra a
MAILING ADI ESS: � � Cb
rl e9-03 t-.. Mir, ek , a1Lc wA 9.212
(street) (crate)
(7.rn)
CONTRACTOR:
MAILING ADDRESS:
(street)
LICENSE 1:
PHONE A:
(city/state) (ZE')
DESCRIPTION OF WORK I J 0 OF UNITS I X I
COST EQUALS AMOUNT
1 FUEL BURNING APPLIANCE - OR < 100,000
1 X 515
2 FUEL BURNING APPLIANCE > 100000
9
3 UNLLSTED APPLIANCE (ADDITIONAL FEE) - OR < 400,000 X 51 X 550
4 UNLISTED APPLIANCE (ADDITIONAL FEE) > 400,000
5 USED APPLIANCE (WSEC min. AFUE rating)X 5100
� or <400,000 X 550
6 USED APPLIANCE (WSEC min. AFUE rating) > 400,000
00
7 BOILER/REFRIGERATIONX 51
1-100M BTU X 515
8 JBOILER/REFRIGERATION ' 101- 500M BTU) I 'X I Szs I
9 BOILER/REFRIGERATION 501-1,000M BTU
10 BOILER/REFRIGERATION 1001 X $39
-1,750M BTU X 557
11 BOILER/REFRIGERATION +1750M BTU
X 595
12 GAS LOG, GAS INSERT, GAS FIREPLACE — ( X $10 = 11)
13 (RANGE
14 (DRYER
15 f FUEL BURNING WATER HEATER
16 IMISC FUEL BURNINGAPPL.
17 (GAS PIPING (ea. Outlet)
18 I DUCT SYSTEMS
J I X I 510
X 1 510 I .
19 (VENTILATING FANS
X 1 Sio 1
X I 510 1
X 1 51 1
' x 1 510 1
20 AIR HANDLER (DOES NOT include ducting) = OR < 10,000CFM X 510
X 512
21 (AIR HANDLER (DOES NOT Include ducting) > 10,000 CFM
X 519
22 EVAPORATIVE COOLERS I
510
23 (TYPE I HOOD
24 JTYPE II HOOD
25 HEAT PUMP/AIR CONDITIONER 1 0-3 TON i i
X J 512
26 AIR CONDITIONER 3-15 TON I I X 520
X I 550 1
X 1 510 1
27 (AIR CONDITIONER
28 JAIR CONDITIONER
29 JAIR CONDITIONER
15-30 TON
30-50 TON
30 JLPG STORAGE TANK
+50 TON'
31 I WOOD OR PELLET STOVE/INSERT
32 I WOOD STOVE - FREE STANDING
X I 525 1
X 1 535 1
X 1 560
X I 510
X I 510
X J 525
METHOD OF PAYMENT
❑ CASH ❑ CHECK ❑
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
SUBTOTAL:
/0.00
PLUS PROCESSING FEE: I $35.00
TOTAL PERMIT FEE DUE: