2004, 06-30 Permit App: BLD-04-04811 ACMECHANICAL PERMIT APPLICATION
PROJECT y
ADDRESS: II
PER
USEtJIIT
G'M` Irry " 1
OWNE':
i14r
PHONE (Daytirto ): 76, ce
MAILING ADDRESS (16
E L_
Street Ci /State Z.
C CTOR:
ttI-,7C✓�ctc.-
LICENSE:
OC7i y .)3544 3 — ec kig MY 000ex.
.
MAILING ADDRESS: ✓
PHONE. -
+4 r .?-akt (1 ° I ' - 192/(2
(Street) SCity/State) (Zip)
DESCRIPTION OF WORK
# OF
UNITS
MULTI-
PByn
er
COST/
UNIT
EQUALS
AMOUNT
FUEL BURNING APPLIANCE
= OR <100..000
X
$12
=
$
FUEL BURNING APPLIANCE
>100,000
X
$15
=
$ "
UNLISTED APPLIANCE (ADDITIONAL CHARGE)
= OR <400,.000
X
$50
=
$
UNLISTED APPLIANCE (ADDITIONAL CHARGE)
>400,000
X
$100
_
$
USED APPLIANCE (Must meet WSEC's min. AFUE rating)
= OR <400,.000
X
$50
=
$
USED APPLIANCE (Must meet WSEC's min. AFUE rating)
>400,000
X
$100
=
$
BOILER/REFRIGERATION
1.100M BTU
X
$12
=
$
BOILER/REFRIGERATION
101-500M BTU
X
$20
=
$
BOILER/REFRIGERATION
501-1,000M BTU
X
$25
=
$
BOILER/REFRIGERATION
1,001- 1,750M BTU
X
$35
--
$
BOILER/REFRIGERATION
+1,750M BTU
X
$60
$
GAS LOG, GAS INSERT, AND/OR GAS FIREPLACE
-
X
$10
=
$
RANGE
-
X
$10
=
$
DRYER
-
X
$10
=
$
FUEL BURNING WATER HEATER
-
X
$10
=
$
MISCELLANEOUS FUEL BURNING APPLIANCE
-
X
$10
=
$
GAS PIPING (ea. Outlet)
-
X
$1
=
$
DUCT SYSTEMS
-
X
$10
=
$
VENTILATING FANS
-
X
$10
=
$
AIR HANDLER (DOES NOT include duct systems)
= OR <10,000 CFM
X
$12
-
$
AIR HANDLER (DOES NOT include duct systems)
>10,000 CFM
X
$15
=
$
EVAPORATIVE COOLERS
-
X
$10
=
$
TYPE I HOOD
-
X
$50
-
$
TYPE II HOOD
-
X
$10
=
$
HEAT PUMP/AIR CONDITIONER
0-3 TONS
(
X
$12
=
$ ! 2
AIR CONDITIONER
3-15 TONS
X
$20
=
$
AIR CONDITIONER
15-30 TONS
X
$25
=
$
AIR CONDITIONER
30-50 TONS
X
$35
=
$
AIR CONDITIONER
+50 TONS
X
$60
=
$
LPG STORAGE TANK
•
X
$10
=
$
WOOD OR PELLET STOVE/INSERT
-
X
$25
=
$
METHOD OF PAYMENT
SUBTOTAL
IICASH 0 CHECK 0 VISA 0 MASTERCARD ❑ DISCOVER
PLUS: PROCESSING FEE
$ 25.00
FAXED PERMITS WILL ONLY BE ACCEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
SUBTOTAL: MINIMUM PERMIT FEE
IS $35.00
DATE: EXPIRES:
PLUS: 16% REGIONAL PLANNING
BANKCARD NUMBER:
SURCHARGE
AUTHORIZED SIGNATURE:
TOTAL PERMIT FEE DUE
Spokane County Division of Building & Code Enforcement
1026 West Broadway Avenue' Spokane, WA 99260-0050
Telephone No. (509) 477-3675 * Fax No. 477-7198 * TDD No. (509) 477-7133