2003, 04-08 Permit App BD03-054 Water HeaterSpokane
d#Valley
Mechanical Permit Application
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206
509-688-0037 - Fax
PROJECT
ADDRESS: lO�OS- E �j�,QA _ 4�
PERMIT ' ,'''r,,,'777 /�
USE: �v`� f �.1
j...� rp /''
1 t'`�v� D U�
OWNER: D/t'Lt, �/ ,%
(�-N
X
PHONE (Daytime Contact):
5'Z i'3 -67(791 O
MAILING ADDRESS:
1
FUEL BURNING APPLIANCE
•OR<100,000
(street)
515
•
(city/state)
2
(ZIP)
> 100,000
CONTRACTOR:
�a
doirf+r,
-
LICENSE :
SGS
98 `$ /
MAILING ADDRESS:
/770
ISS 02
C04
:k
PHONE
4
UNLISTED APPLIANCE (ADDITIONAL FEE)
>400,000
0
e381V'
(street)
(city/state)
USED APPLIANCE (WSEC min. AFUE rating)
(ZIP)
METHOD OF PA
❑ CASH ❑ C
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE
DESCRIPTION OF WORK
4 OF UNITS
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 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 BN
X
595
-
12
CAS LOG, GAS INSERT, GAS FIREPLACE
-
X
510
-
13
RANGE
-
X
510
-
14
DRYER
-
X
510
-
15
FUEL BURNING WATER HEATER
-
X
510
•
g ®, F
16
MISC FUEL BURNING APPL
-
X
510
-
17
GAS PIPING (ea Outlet)
-
X
51
-
18
DUCT SYSTEMS
-
X
510
-
19
VENTILATING FANS
-
X
510
•
20
AIR HANDLER (DOES NOT include ducang)
- 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/AIRCONDTTIONER
0-3 TON
X
512
-
26
AIR CONDITIONER
3-15 TON
X
520
•
27
AIR CONDITIONER
15-30 TON
X
525
-
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 - FREE STANDING
-
X
525
•
)(LENT
rEii
SUBTOTAL:
PLUS PROCESSING FEE:
$35.00
TOTAL PERMIT FEE DUE: Zig It)
VISA.: ,t s
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE