2003, 10-21 Permit App BLD-03-02832 Mechanical FixturesS °ohne
�,,��Valley
Mechanical Permit Application
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA'99206
509-688-0037 - Fax
PROJECT %�%
ADDRESS: S 0,__.- p,e r'�,e 5��� U
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USE
OWNER O.Dct 1.4-e (..,
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PHONE (Daytime Contact):
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MAILING ADDRESS:
S ���5
V��,ert �-
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ijs-' 1.5.8.0
2 0‘
(street)
(city/state)
-
(ZIP)
-
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CONTRACTOR: , /
/ '
I f
FUEL BURNING APPLIANCE
> 100,000
LICENSE #:
X
$19
MAILING ADDRESS:
PHONE #:
UNLISTED APPLIANCE (ADDITIONAL FEE)
- OR < 400,000
X
$50
(street)
(city/state)
(ZIP)
UNLISTED APPLIANCE (ADDITIONAL FEE)
METHOD OF PA
❑ CASH ❑ C
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
(45
C ci S
..,//
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DESCRIPTION OF WORK
# OF UNITS
X
COST
EQUALS
AMOUNT
1
FUEL BURNING APPLIANCE
- OR < 100,000
X
515
-
-
:-...z'
2
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
528
-
9
BOILER/REFRIGERATION
501 - 1,000M BTU
X
539
-
10
BOILER/REFRIGERATION
1001-1,750M BTU
X
$57
=
11
BOILER/REFRIGERATION
+1750M BTU
X
595
-
12
GAS LOG, GAS INSERT, GAS FIREPLACE
-
i
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)
-
- ."L
X
51
-
L '=.
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 include ducting)
> 10,000 CFM
X
519
-
22
EVAPORATIVE COOLERS
-
X
510
-
23
TYPE I HOOD
-
X
850
-
24
TYPE II HOOD
-
X
510
-
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
X
512
-
26
AIR CONDITIONER
3-15 TON
X
$20
-
27
AIRCONDITIONER
15-30 TON
X
525
=
28
AIR CONDITIONER
30-50 TON
X
535
-
29
AIR CONDMONER
+50 TON
X
560
-
30
LPG STORAGE TANK
-
X
510
-
31
WOOD OR PELLET STOVE/INSERT
-
X
510
-
32
WOOD STOVE - FREE STANDING
-
X
525
-
KENT
VISA';Vast, `
SUBTOTAL:
PLUS PROCESSING FEE:
$35.00
TOTAL PERMIT FEE DUE:
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
(45
C ci S
..,//
,,e,) hd,,e, ji