2003, 04-22 Permit: BD-03-124 Mechanical FixturesSCITY (a ►
pane
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206
,0,,.Val ley s(41.
Mechanical Permit Application
509-688-0037 - Fax
(A- 124
PROJECT/
ADDRESS: 3/S:. ,ie e y q Lie_
PERMIT �4��
USE: F t? p I v f
OWNER: n C -I 0 a( 6y
PHONE (Daytime Contact):
MAILING ADDRESS: / -+e tie / j (r , �!/q
3/'? Sr 5Ze7/G- r 4 iges-e4/ 9? m3 )?
(street) (city/state) (ZIP)
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CONTRACTOR: /� /Z /� /�a H LICENSE #: ALIO.,
/l t [ O7o l<, >
/ [ f �7' C l�
MAILING ADDRESS:
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S'!'0/4e)
PHONE #: / ` / n ,Wq
C� GJ��
41/ 91.07(96
(street) (city/state) (ZIP)
METHOD OF PAYMENT
VISA'
0 CASH 0 CJ -HECK 0 111111111111111
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
SUBTOTAL:
I 00
PLUS PROCESSING FEE:
$35.00
TOTAL PERMIT FEE DUE:
`i(
DESCRIPTION OF WORK
8 OF UNITS
X
COST
EQUALS
AMOUNT
1
FUEL BURNING APPLIANCE
- OR < 100,000
X
515
-
tiiiMar
2
FUEL BURNING APPLIANCE
> 100,000
X
519
-
3
UNLISTED APPLIANCE (ADDITIONAL FEE)
= OR <400,000
X
$50
-
4
UNLISTED APPLIANCE (ADDITIONAL FEE)
> 400,000
X
5100
-
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
515
-
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
557
-
11
BOILER/REFRIGERATION
+1750M BTU
X
595
-
12
GAS LOG, GAS INSERT, GAS FIREPLACE
-
!
X
510
-
/ 0. Q)
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
$12
=
21
AIR HANDLER (DOES NOT include ducting)
> 10,000 CFM
X
$19
-
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
$25
=
28
AIR CONDITIONER
30-50 TON
X
$35
-
29
AIR CONDITIONER
+50 TON
X
560
-
30
LPG STORAGE TANK
-
X
510
-
31
WOOD OR PELLET STOVE/INSERT
-
X
$10
-
32
WOOD STOVE - FREE STANDING
-
X
525
-
METHOD OF PAYMENT
VISA'
0 CASH 0 CJ -HECK 0 111111111111111
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
SUBTOTAL:
I 00
PLUS PROCESSING FEE:
$35.00
TOTAL PERMIT FEE DUE:
`i(
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