2003, 05-13 Permit App: BD-03-749 Mechanical FixturesswC11Yc 00p, �� 11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
ake Spokane Valley, WA 99206 509-688-0037 - Fax
�Val1e For Inspections, call 509-688-0054
-Mechanical Permit A
lication 1� _ 7�/
PROJECT
ADDRESS: !� `� A0/0 l C'TUSE:
PERMIT
OWNER P12r— r�
PHONE (Daytime Contact):
MAILING ADDRESS:
- OR < 100,000
(street) (city/state)
(gyp)
CONTRACTOR: r to Z V r✓t a k/ 1'
LICENSE t:
MAILING ADDRESS: / 2-Z�P��✓J��' % = 1 67—
!
5-P o e,
PHONE #: �
Y� rj (� Z ; y� ry
7 I
(street) (city/state)
(ZIP)
METHOD OF PAY
❑ CASH
DATE: _
DESCRIPTION OF WORK
# 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
550 -
4 UNLLSTED 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 BOILERIREFRICERA71ON
1- loom BTU
X
$15 -
8 BOILER/REFRIGERATION
101- 500M BTU
-:x
528 -
9 BOILER/REFRIGERATION
501-1,000M BTU
X
$39
W BOILER/REFRIGERATION
1001-1,750M BTU
X
$57 =
11 BOILERIREFRIGERATION
+1750M BTU
X
$95
12 GAS LOG, GAS INSERT, GAS FIREPLACE
-
X
$IO
13 RANGE
-
X
$10 -
14 DRYER
-
X
$10 =
15 FUEL BURNING WATER HEATER
-
X
$10
16 MISC FUEL BURNING.APPL.
-
X
$10
17 GAS PIPING (ea. Outlet)
-
18 DUCT SYSTEMS
-
X
$10 -
19 VENTILATING FANS
-
X
510 -
20 AIR HANDLER (DOES NOT Include ducting)
- OR < 10,000CFM
X
$12
21 AIR HANDLER (DOES NOT indude 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 PUSe/AIR CONDITIONER
0-3 TON
X
$12
26 AIR CONDITIONER
3-15 TON
X
$20
27 AIRCONDITIONER
15-30 TON
X
$25 =
28 AIR CONDITIONER
30-50 TON
X
$35 -
29 AIR CONDITIONER
+50 TON
X
$60
30 LPG STORAGE TANK
-
X
$10 -
31 IWOOD OR PELLETSTOVE/INSERT
-
X
$10-
32 LWOOD STOVE - FREE STANDING
_
X
$25 _
TIENT
am VOW
rn n
SUBTOTAL:
PLUS PROCESSING FEE: $35.00
TOTAL PERMIT FEE DUE:
❑ CHECK
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
EXPIRES:
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