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2003, 11-14 Permit App: BLD-03-03074 Wood Stove
Spokane valley Mechanical Permit Application 11707 EasYSpragtre Avenue, Suite 106 509-688-0036 - Phone 509-688-0037 - Fax Spokane Valley, WA 99206 PROJECT / ,.� �,/ ADDRESS: � 9" (9 IV . L� ".r`.�"USE: OWNER: M) 0.K ` f' ( -boa 04.61 L�� PHONE (Daytime Contact): Q •-.MAILING 1 CPA e--a- ADDRESS: Sa-I4 /J (Y\C_Dd-+1nQc. AMOUNT (street) a p Kt,. A (city/state) A_ (ZIP) —` "'l Ct (3( 1� CONTRACTOR LICENSE 1: MAILING ADDRESS: - PHONE d: 2 FUEL BURNING APPLIANCE (street) (city/state) (ZIP) - METHOD OF PA ❑ CASH 0 DATE: EXPIRES: BANKCARD NUMBER: AUTHORIZED SIGNATURE: DESCRIPTION OF WORK F OF UMTS X COST EQUALS AMOUNT 1 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 613 X 515 • 8 BOILER/REFRIGERATION 101- 500M BTU X 528 - 9 BOILER/REFRIGERATION 501- 1,000M BTU - X 539 • 10 BOILER/REFRIGERATION 1001- L750M BTU X $57 • 11 BOILER/REFRIGERATION •1750M BTU X 595 • 12 GAS LOG, GAS INSERT, GAS FIREPLACE - X $10 • 13 RANGE - X 510 • 14 DRYER' - - X 510 - 15 FUEL BURNING WATER HEATER - - X 510 • 16 MISC FUEL BURNINGAPPL - --- -. _ - X- - ---510- • - - - •-- - — ---- - - - - i17 i 17 GAS PIPING (ea Outlet)- - X 51 • 18 DUCT SYSTEMS - X 510 - 19 VENTILATING FANS - X 510 • 20 AIR HANDLER (DOES NOT Include ducting) • OR < I0,000cPM X 512 21 AIR HANDLER (DOES NOT Include ddcing) > 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 AIRCONDn10NER 3-I5 TON X 520 • 27 AIR CONDITIONER 15-30 TON X 525 • 28 AIR CONDTIONER 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 - 1 X 525 • 00 ✓�' JJ HENT yY =rt. -f1 3 r --:I iksf ,r t±C-7 J, SUBTOTAL: PLUS PROCESSING FEE $35.00 TOTAL PERMIT FEE DUE: r -/1 I) 6 il/ 1 DATE: EXPIRES: BANKCARD NUMBER: AUTHORIZED SIGNATURE: