2003, 10-27 Permit App: BLD-03-02904 Mechanical Fixtures •
SCalm c>I 11707 East Sprague Avenue,Suite 106 509-688-0036-Phone
pokane Spokane Valley,WA 99206 509-688-0037-Fax
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•Mechanical Permit Application
PROJECT - PERMIT
S
ADDRESS: �/0 S - JA()6 . S
USE:
OWNER: /4_10 Q ) 6L,ES r PHONE(Daytime Contact): 70/_ Sf .as.>
MAILING ADDRESS: r
(street) (city/state) (ZIP)
CONTRACTOR: / � LICENSE S:
MAILING ADDRESS: ' /mac PHONE 5: f c ]
0 c 7 S A.'1 :-/ZAI :2
(street) (city/state) (ZIP)
DESCRIPTION OF WORK #OF UNITS X COST EQUALS AMOUNT
1 FUEL BURNING APPLIANCE -OR<100,000 / X ' $15 /S -CJ(
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 $15 =
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 BURNINGAPPL. - X $10 _
17 GAS PIPING(ea.Outlet) - / X $1 = / Oct
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 CONDMONER 0-3 TON / X $12 = /Z ,Ov
26 AIR CONDITIONER 3-15 TON X $20 =
27 AIR CONDITIONER 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 WOOD OR PELLET STOVE/INSERT - X $10 =
32 WOOD STOVE-FREE STANDING - X $25 =
SUBTOTAL: _oo
METHOD OF PAYMENT PLUS PROCESSING FEE: $35.00
/ it f -' TOTAL PERMIT FEE DUE 3 00
❑ CASH CHECK ❑ ❑ 1.._ —.-
DATE: / Z? - & ( EXPIRES:
BANKCARD NUMBER
AUTHORIZED SIGNATURE: