2004, 09-27 Permit App: BLD-04-07774 Water Heater ar 11707 East Sprague Avenue,Suite 106 509-688-0036-Phone
Mane Spokane Valley,WA '99206 509-688-0037-Fax
,, 000 Valley
•Mechanical Permit Application
•
PROJECT PERMIT
ADDRESS: i S6 I / r 1 USE: .
OWNER: ��,v. / PHONE(Daytime Contact): 9z }Q D,- L 7/
MAILING ADDRESS: !
(street) (city/state) (ZIP)
CONTRACTORy r te n T LICEN !1: 3Gs ?8 �/
/
MAILING ADDRESS: PHONE 66 6 r
,1720 ,?)� e..ham- .7) 'R 1 .
(street) (city/state) (ZIP)
DESCRIPTION OF WORK #OF UNITS X COST EQUALS AMOUNT
S
1 FUEL BURNING APPLIANCE -OR<100,000 X $15 -
2 FUEL BURNING APPLIANCE >100,000. X $19 -
3 UNLISTED APPLIANt;E(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 - /P
16 MISC.FUEL BURNING APPL. • - X $10 -
17 GAS PIPING(ea.Outlet) - X $1 •
-
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 -
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 +$0 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: /0
METI-rOD OF PAYMENT PLUS PROCESSING FEE: $35.00
NOM '' TOTAL PERMIT FEE DUE:
VISA"• '
❑ CASH `�,7{ CHECK ❑ ❑ —_ - L-4..i ~
DATE: ' EXPIRES:
BANKCARD NUMBER;
AUTHORIZED SIGNATURE: