2003, 06-24 Permit App: BD-03-641 Mechanical Fixtures('JT1' ( �I� w�
Spalane
Mechanical Permit Application
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206 509-688-0037 - Fax
For Inspections, call 509-688-0054
6D05-1041
PROJECTPEMIT
ADDRESS: (a/Sp £-ee s,. Gii
USE:
OWNER: rtip/ ((/!J v ei -
PHONE (Daytime Contact): f,777 _��2 C/ 7
MAILING ADDRESS: ZC,�%. S' ,47.eeS ` 4 G a �// /e r ��
Cr, f(ZIP)
(street) (city/state)
CONTRACTOR: `/2g?1 v /, spa
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LICENSE #: ���[/��/fi
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MAILING ADDRESS:
v/re
PHONE #: - n
a//c1X92/2
(street) (city/state) (ZIP)
METHOD OF PA
0 CASH 0 CHECK 0 ❑ !
DATE:
EXPIRES:
BANKCARD NUMBER
AUTHORIZED SIGNATURE:
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
$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 BURNING APPL.
-
X
$10
-
17
GAS PIPING (ea. Outlet)
-
X
81
=
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 CONDITIONER
0-3 TON
X
$12
=
k /7
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
810
-
31
WOOD OR PELLET STOVE/INSERT
-
X
$10
=
32
WOOD STOVE - FREE STANDING
-
X
$25
-
VIENTPLUS
•..
VISA' :�"2�4�e�
SUBTOTAL:
PROCESSING FEE:
$35.00
TOTAL PERMIT FEE DUE: LI 7.---a-'
r
0 CASH 0 CHECK 0 ❑ !
DATE:
EXPIRES:
BANKCARD NUMBER
AUTHORIZED SIGNATURE: