2003, 10-10 Permit App: BLD-03-02734 Furnace, Piping Sc3Tr t>F 11707 East tpragu�Avenue, Suite 106 509-688-0036-Phone
pO ne Spokane Valley,WA 99206 509-688-0037-Fax
....*Valley'
,, . Valley
Mechanical Permit Application
PROJECT ZN/c4 S. T.—h ,-.Q___. PERMIT /- /�
ADDRESS: , e4L , L' L-� .."1-)� �' USE: 7/4.4.C "''4�a�/'
OWNER: S�p� tea)/44_, PHONE(Daytime Contact): o
MAILING ADDRESS:
(street) (city/state) (ZIP)
CONTRACTOR ,Qw��— LICENSE#:
P T A.rcC 976)J'!-)74/
MAILING ADDRESS: -' PHONE#:
)o- 677?
(street) (city/state) (ZIP)
DESCRIPTION OF WORK 8 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 I-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 $1 = I
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 +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:
METHOD OF PAYMENT PLUS PROCESSING FEE: $35.00
MEM VISA • l; TOTAL PERMIT FEE DUE S/ �--•
❑ CASH ❑ CHECK ❑ ❑ !__ _-_T
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: