2004, 02-17 Permit App: BLD-04-03562 Water Heater*Wane
.0,01vaHey
11707 East ,,pragiip Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206 509-688-0037 - Fax
For Inspections, call 509-688-0054
Mechanical Permit Application
PROJECT /
ADDRESS: J 6 ib
A� ^ q /
044
�. P��L..k1N4i� Rpt
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USE: (�QI. i
/
4', 4
OWNER M /,P
tS
Moll
AMOUNT
PHONE (Daytime Contact):
co9 a'9/ Zoe 5
MAILING ADDRESS:
S
y /
AC-6011°W V- A011° f/
Sjkor4e Va/ /
�, (414
99z16
(street)
(city/state)
(ZIT)
FUEL BURNING APPLIANCE
CONTRACTOR.
X
LICENSE I:
•
MAILING ADDRESS:
3
UNLISTED APPLIANCE (ADDITIONAL FEE)
PHONE #:
X
550
(street)
(city/state)
(ZIP)
UNLISTED APPLIANCE (ADDITIONAL FEE)
METHOD OF PA
❑ CASH ❑ C
DATE:
EXPIRES:
BANKCARD NUMBER
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
8 OF UNITS
X
COST
EQUALS
AMOUNT
t
FUEL BURNING APPLIANCE
•OR<100,000
X
515
-
2
FUEL BURNING APPLIANCE
> 100,000
X
519
•
3
UNLISTED APPLIANCE (ADDITIONAL FEE)
• OR<400,000
X
550
-
4
UNLISTED APPLIANCE (ADDITIONAL FEE)
> 400,000
X
5100
-
5
USED APPLIANCE (WSEC min AFUE rating)•
or < 400,000
X
550
-
6
USED APPLIANCE (WSEC min. AFUE rating)
> 400,000
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
539
•
10
BOILER/REFRIGERATION
1001 - 1,750M BTU
X
557
•
11
BOILER/REFRIGERATION
+1750M BTU
X
595
•
12
GAS LOG, GAS INSERT, GAS FIREPLACE
-
X
510
•
13
RANGE
-
X
510
•
14
DRYER
-
X
510
•
15
FUEL BURNING WATER HEATER
--
X
510
(0 ==
16
MISC. FUEL BURNING APPL.
-
X
510
-
17
CAS PIPING (ea. Outlet)
-
X
51
•
18
DUCT SYSTEMS
-
X
510
•
19
VENTILATING FANS
-
X
510
-
20
AIR HANDLER (DOES NOT include ducting)
•014< 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 CONDITIONER
0-3 TON
X
512
-
26
AIR CONDITIONER
3-15 TON
X
520
•
27
AIRCONDITIONER
15-30 TON
X
S25
•
28
AIR CONDITIONER
30-50 TON
X
535
•
29
AIR CONDITIONER
+50 TON
X
560
•
30
LPG STORAGE TANK
-
X
510
•
31
WOOD OR PELLET STOVE/INSERT
-
X
. 510
•
32
WOOD STOVE - FREESTANDING
-
X
525
vIENT
_ r_
SUBTOTAL:
GO
/O —
PLUS PROCESSING FEE:
$35.00
TOTAL PERMIT FEE DUE: j/S-
DATE:
EXPIRES:
BANKCARD NUMBER
AUTHORIZED SIGNATURE: