2003, 12-16 Permit App: BLD-03-03287 Gas Log, PipingSpokane
.00FUalley
Mechanical Permit Application
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206 509-688-0037 - Fax
For Inspections, call 509-688-0054
P E
AROT RESS: 1132 "t L IilUA-FI p yl,) e rtt
USE:PERMIT
OWNER f D q I „ / vWL a �,tS
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PHONE (Daytime Contact): 22-90 -^33 -f \„\L---/
MAILING ADDRESS
15-00'5 LT- 13f ora Sp o, 9gzlla
(street) (ci state) (ZIP)
CONTRACTOR. SpCJICAL>Q cvN\tM vNa *ye i.._
..
AMOUNT
LICENSE �J
It So DIC A c V9 o /Ji
MAILING ADDRESS: d
I560S k?.-- c 6'on
(,i a, (----4 c11921-17/
PHONE
�7�9— S�3���Z0
I
1/3°%l / i/w/o4
(street) (city/state) m ( d ( Sf- Cn—
METHOD OF PA
❑ CASH ❑ c
DATE:
EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
8 OF UNITS
X
COST
EQUALS
AMOUNT
1
FUEL BURNING APPLIANCE
• OR c 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 mm 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
-
no'
1 O 4-----
13
RANGE
--
X
510
•
14
DRYER
-
X
510
-
15
FUEL BURNING WATER HEATER
-
X
510
-
16
MISC FUEL BURNING APPL.
-
X
510
-
'
17
GAS PIPING (ea Outlet)
-1
X
Sl
•
O Q
18
DUCT SYSTEMS
-
X
510
•
19
VENTILATING FANS
-
X
$10
•
20
AIR HANDLER (DOES NOT include ducting)
• OR < 10,000CFM
X
512
•
21
AIR HANDLER (DOES NOT include ducting)
> 10,000 CFM
X
519
•
21
EVAPORATIVE COOLERS
-
X
510
-
23
TYPE I HOOD
-
X
$50
-
24
TYPE II HOOD
-
X
510
-
25
HEAT PUMP/AIRCONDrITONER
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
523
•
HENT
SOS
VISA _.r t
SUBTOTAs
L
I I L `
PLUS PROCESSING FEE:
$35.00
TOTAL PERMIT FEE DUE: LI 6 . II 6
DATE:
EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: