2004, 01-14 Permit App: BLD-04-03409 Dryer, Piping Sy(�nnYc. 11707 East Sprague;Avenue,Suite 106 509-688-0036-Phone
ne Spokane Valley,WA 99206 509-688-0037-Fax
4000 ValleY For Inspections, call 509-688-0054
,Mechanical Permit Application 6 4'' 0
PROJECT /70/ S. STi#- iky LA/ PERMIT
ADDRESS: USE:
OWNER: 'frhK K PHONE(Daytime Contact):
MAILING ADDRESS:
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(street) (city/state) (ZIP)
CONTRACTOR: b--; /0' �r �� � LICENSE#: go i'T 1L/qa
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MAILING ADDRESS: �f PHONE#:
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(street) (city/state) (ZIP) �)
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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 =
Cii/:
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 = Y/
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 = 5N'S\\
12 GAS LOG,GAS INSERT,GAS FIREPLACE — X $10
13 RANGE — X $10 =
14 DRYER — X $10 = 1/9/P
15 FUEL BURNING WATER HEATER — )( $10 - Th
16 MISC FUEL BURNING APPL. — X $10 = \/ i,
17 GAS PIPING(ea.Outlet) — X $1 = J l �...
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 IHOOD — 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 +50 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: 6( L)0
METHOD OF PAYMENT PLUS PROCESSING FEE: $35../00
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- ' TOTAL PERMIT FEE DUE: Li(, 00
❑ CASH El CHECK ❑ ElL_" .`mph
DATE: EXPIRES:
BANKCARD NUMBER
AUTHORIZED SIGNATURE: