2003, 10-29 Permit App: BLD-03-02939 Furnace, PipingStiiikan� ems"°'
.#Valley
Mechanical Permit Application
11707 East Sprague Avenue, Suite 106
Spokane Valley, WA 99206
509-688-0036- Phone
509-688-0037 - Fax
METHOD OF PA
0 CASH 0
PROJECT / /J
ADDRESS- At a2-0 _7 inCia)A/4 /J la
PERMIT USE:
OWNER IA.4 Ir-. %
n , A :' i ,Lp
Y " L
PHONE Contact): '
(Daytime
9 / � l
-
MAILING ADDRESS:
N • Yiv ?
Oe
M cdoivq (4.v ic-e S(2/1-ivc-//e�� bf4- 990)
(street)
(city/state) (ZIP)
CONTRACTOR: \rt,y}
VV), I ' er
LICENSE #:
MAILING ADDRESS: - •
em. G5 4bei.�
PHONE k:
gni a -2_13,,__s
2
(street)
(city/state) (ZIP)
METHOD OF PA
0 CASH 0
DATE: /o -0,2 EXPIRES:
BANKCARD NUMBER: ,,�,¢�
AUTHORIZED SIGNATURE: "/ �/�"
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DESCRIPTION OF WORK
-
4 OF UNITS
X
COST
EQUALS
AMOUNT
1
FUEL BURNING APPLIANCE
• OR < 100,000•
X
' 515
2
FUEL BURNING APPLIANCE r
> 100,000
1
X
519
-
3
UNLISTED APPLIANCE (ADDITIONAL FEE)
•OR < 400,000
X
550
4
UNLISTED APPLIANCE(ADDn-ONAL FEE)
>400,000
X
5100
•
5
USED APPLIANCE (WSEC min AFUE rating)
• or <400,000
X
• 550
•
6
USED APPLIANCE (WSEC min. AFUE rating)
> 400000
X
5100
•
7
BOILER/REFRIGERATION
1 - 100M BTU
X
515
•
8
BOILER/REFRIGERATION
101 - 500M BTU
X
528
-
9
BOILER/REFRIGERATION
501 . 1,000M BTU
X
$39
•
10
BOILER/REFRIGERATION
1001 . 1,750M BTU
X
557
•
11
BOILER/REFRIGERATION
+1750M BTU
X
595
-
12
GAS LOG, CAS INSERT, GAS FIREPLACE
-
X
510
-
13
RANGE
-
X
510
-
14
DRYER
-
X
510
-
15
FUEL BURNING WATER HEATER
MISC FUEL BURNING APPL
-
-
X
510
•
16
- ---
-- -_.
...
X- ---510-
•---
--------- -
___
;�
OASPIPING(ea.Outlet)
- -
l
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
EVAPORATIVE COOLERS
-
-
X
510
.-
23
TYPE I HOOD
-
X
550
•
24
TYPE II HOOD
-
X
510
•
25
HEAT PUMP/AIR CONDRIONER
0-3 TON
X
512
•
26
AIR CONDITIONER
3-15 TON
X
520
- '
27
AIRCONDMONER
15-30 TON
X
525
•
28
AIRCONDTHONER
30-50 TON
X
535
29
AIRCONDITIONER
X50 TON
X
560
•
30
LPG STORAGE TANK
-
X
510
•
31
WOOD OR PELLET STOVE/INSERT
-
X
- 510
-
32
WOOD STOVE - FREESTANDING
-
X
525
•
HENT
VISA'
TCPY n IIIMINIBIO rI
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SUBTOTAL:
-,/ o 13
PLUS PROCESSING FEE
$35.00.
TOTAL PERMIT FEE DUE: j 36,
DATE: /o -0,2 EXPIRES:
BANKCARD NUMBER: ,,�,¢�
AUTHORIZED SIGNATURE: "/ �/�"
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