2003, 10-06 Permit App: BLD-03-02692 Pellet Stove[TIe c ./" 4,
Spo' .ne
,,r,, .. Valley
Mechanical Permit Application
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206
509-688-0037 - Fax
PROJECT
ADDRESS: /J /
"ti -77-0"e...._
PERMIT
USE:
OWNER: r(t.
,o `A 2.„2_1-- -PHONE
(Daytime Contact):
MAILING AD RESS:
/ 27 -5-,
i." -c c% C ,77-
(street)
(city/state)
(Z1P)
CONTRACTOR:
LICENSE #:
MAILING ADDRESS: •
PHONE #:
(street)
(city/state)
(ZIP)
DESCRIPTION OF WORK
It OF UNITS
X
COST
EQUALS
AMOUNT
1
FUEL BURNING APPLIANCE
= OR < 100,000
X
' 515
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
. 550
6
USED APPLIANCE (WSEC min. AFUE rating)
> 400,000
X
5100
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
557
11
BOILER/REFRIGERATION
+1750M BTU
X
$95
12
GAS LOG, GAS INSERT, GAS FIREPLACE
X
510
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)
X
51
18
DUCT SYSTEMS
X
510
19
VENTILATING FANS
X
510
20
AIR HANDLER (DOES NOT include ducting)
= OR < 10,000CFM
X
512
21
AIR HANDLER (DOES NOT indude ducting)
> 10,000 CFM
X
519
22
EVAPORATIVE COOLERS
X
510
23
TYPE I HOOD
X
$50
24
TYPE II HOOD
X
510
25
HEAT PUMP/AIR CONDITIONER
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
$35
29
AIR CONDITIONER
+50 TON
X
$60
30
31
LPG STORAGE TANK
X
510
OOD OR PELLET STOVE/INSERT
X
$10
32
WOOD STOVE - FREE STANDING
X
525
METHOD OF PAYMENT
0 CASH 0 CHECK ❑
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
SUBTOTAL:
PLUS PROCESSING FEE:
$35.00
TOTAL PERMIT FEE DUE: