2003, 05-20 Permit App: BD-03-999 Mechanical FixturesOlt OE
Bene
Mechanical Permit Application
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206
509-688-0037 - Fax
PROJECT
ADDRESS: .;)2 «6 5 E 0 l i X e/- 7r
PERMIT
USE: )0/0,04 Z (,,,,�S s
)_/,, op IG
OWNER ��/ I P `th/ ,S b i- %'
PHC(NE (Daytime Contact):
094s
MAILING ADDR S:
/ -2-- V' G -s •
/ t Y )) /- P15��i
WA 9
/
(street)
(city/state) / (ZIP)
CONTRACTOR:..vey/n
!
LICENSE #:
MAILING ADDRESS:
PHONE #:
(street)
(city/state) (ZIP)
/P/t, 61 /7
1
DESCRIPTION OF WORK
FUEL BURNING APPLIANCE
✓r OF UNITS
X
COST
EQUALS
AMOUNT
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
BOIL ER/REFRIGERATION
1001 - 1,750M BTU
X
557
11
BOILER/REFRIGERATION
+1750M BTU
X
595
12
GAS LOG, GAS INSERT, GAS FIREPLACE
X
510
13
RANGE
X
510
ry
14
DRYER
X
510
15
FUEL BURNING WATER HEATER
X
510
16
MISC. FUEL BURNING APDL.
X
510
17
GAS PIPING (ea. Outlet)
X
51
1$
DUCT SYSTEMS
-- 510
I
19
VENTILATING FANS
X
510
20
AIR HANDLER (DOES NOT include ducting)
OR < 10,000CFM
X
512
21
AIR HANDLER (DOES NOT include ducting)
> 10,000 CFM
X
819
22
EVAPORATIVE COOLERS
X
810
23
TYPEIHOOD
X
850
24
TYPE II HOOD
X
510
25
HEAT PUMP/AJR CONDITIONER
0-3 TON
X
512
26
AIR CONDLTIONER
3-15 TON
X
$20
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
$10
31
32
WOOD OR PELLET STOVE/INSERT
X
510
/b
WOOD STOVE - FREE STANDING
X
525
METHOD OF PAYMENT
vU. •
❑ CASH ❑ CHECK 0
DATE:
EXPIRES:
BANKC:ARD NUMBER:
AUTHORIZED SIGNATURE:
SUBTOTAL:
,l
PLUS PROCESSING FEE:
$35.00
TOTAL PERMIT FEE DUE: 5
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