2006, 05-23 Permit App: 06001955 Heat Pump, ACSilolane
,�iValley
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206 509-688-0037 - Fax
For Inspections, call 509-688-0054
4cirl,P1D
Mechanical Permit Application
PROJECT
ADDRESS: 6' 5 (,I b C� m 155169YJ
PERMIT
USE:
8 OF UNITS
p
OWNER I� i 1) iT� m
ps
COST
PHONE (Daytime Contact):
,2'
2 073 /
7
MAILING ADDRESS:
b L. crit
15/GS/oly
spv vft,
- OR < 100,000
9 -o6
(street)
$15
(city/state)
(ZIP)
2
FUEL BURNING APPLIANCE
CONTRACTOR: A l•(�
tL
`..
Y�-LJ
X
LICENSE #:
t a
l` `
L 990 d ,Q
3 J L�
MAILING ADDRESS:
5517 e iniAt lvAi
SDI -Aa.F U lv (,.
(city/state)
PHONE It:
(J
5) 7_ -r 3 � ,
7,33
,3 3 3
$50
99L
(ZIP)
4
(street)
METHOD OF PA
❑ CASH 0
DATE:
EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
8 OF UNITS
X
COST
EQUALS
AMOUNT
1
FUEL BURNING APPLIANCE
- OR < 100,000
X
$15
•
2
FUEL BURNING APPLIANCE
> 100,000
X
$19
-
3
UNLISTED APPLIANCE (ADDITIONAL FEE)
- OR <400,000
X
$50
-
4
UNLISTED APPLIANCE (ADDITIONAL FEE)
> 400,000
X
$100
•
5
USED APPLIANCE (WSEC min. AFUE rating)
• or <400,000
X
$50
-
6
USED APPLIANCE (WSEC min. AFUE rating)
> 400,000
X
$100
-
7
BOILER/REFRIGERATION
1-100M BTU
X
515
-
8
BOILER/REFRIGERATION
101- 500M BTU
X
$28
-
9
BOILER/REFRIGERATION
501-1,000M BTU
X
$39
•
10
BOILER/REFRIGERATION
1001-1,750M BTU
X
$57
-
11
BOILER/REFRIGERATION
+1750M BTU
X
$95
-
12
GAS LOG, GAS INSERT, GAS FIREPLACE
-
X
$10
-
13
RANGE
-
X
$10
-
14
DRYER
-
X
$10
•
15
FUEL BURNING WATER HEATER
-
X
$10
-
16
MISC. FUEL BURNING ADPL.
-
X
$10
•
17
GAS PIPING (ea. Outlet)
-
X
Sl
-
18
DUCT SYSTEMS
-
X
$10
-
19
VENTILATING FANS
-
X
$10
•
20
AIR HANDLER (DOES NOT include ducting)
- OR < 10,000CFM
X
$12
-
21
AIR HANDLER (DOES NOT include ducting)
> 10,000 CFM
X
$19
-
22
EVAPORATIVE COOLERS
-
X
$10
-
23
TYPE I HOOD
-
X
$50
-
24
TYPE II HOOD
-
X
$10
•
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
1
X
$12
•
/2,
26
AIR CONDITIONER
3-15 TON
X
$20
-
27
AIR CONDITIONER
15-30 TON
X
$25
-
28
AIR CONDITIONER
30-50 TON
X
535
-
29
AIR CONDITIONER
+50 TON
X
S60
-
30
LPG STORAGE TANK
-
X
$10
-
31
WOOD OR PELLET STOVE/INSERT
-
X
$10
•
32
WOOD STOVE - FREE STANDING
-
X
$25
•
LIENT
VISA'
n rte n n
_
reasfMOM O!'
ste,
SUBTOTAL:
t2•00
PLUS PROCESSING FEE:
$35.00
TOTAL PERMIT FEE DUE: 14 7 r
EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: