HomeMy WebLinkAbout2003, 12-16 Permit App: BLD-03-03288 Mechanical Fixtures*Wane
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Mechanical Permit Application
11707 East Sp vague Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206 509-688-0037 - Fax
For Inspections, call 509-688-0054
PROJECT
ADDRESS: '97-0
DESCRIPTION OF WORK
Uslom.
PERMIT
USE:
OWNER Ce. .S�'�
sv
EQUALS
PHONE (Daytime Contact): 7
MAILING ADDRESS:
.43-7_40 S . L4✓4i 1:ti
FUEL BURNING APPLIANCE
-C./1014W? ?''_t t/G4 ge
L`"b /9 2 11
(street)
$15
• (city state)
(ZIP)
CONTRACTOR: IA. r- 1.-
"�
�-
O
LICENSE #:
X
MAILING ADDRESS:
-
Sr.514
PHONE #:
A.46 �d 1-67
- OR <400,000
1 virl !, 1,,p ,g21tb
(street)
$50
(city/state)
(ZIP)
METHOD OF PA
0 CASH
❑ C
DATE: EXPIRES:
BANKCARD NUMBER
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
9 OF UNITS
X
COST
EQUALS
AMOUNT
1
FUEL BURNING APPLIANCE
- OR < 100,000
.,
X
$15
-
/ S
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
S50
-
6
USED APPLIANCE (WSEC min. AFUE rating)
> 400,000
X
$100
7
BOILER/REFRIGERATION
1 - 100M BTU
X
515
-
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
51
1
18
DUCT SYSTEMS
-
�
X
$10
-
I D
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
510
-
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
560
30
LPG STORAGE TANK
-
X
810
-
31
WOOD OR PELLET STOVE/INSERT
-
X
$10
-
32
WOOD STOVE - FREE STANDING
-
X
825
-
KENT
VISA' �st1
SUBTOTAL:
2
PLUS PROCESSING FEE:
$35.00
TOTAL PERMIT FEE DUE: k / '
DATE: EXPIRES:
BANKCARD NUMBER
AUTHORIZED SIGNATURE:
• PART 1
•
Residence Address
KEY FORMS & GRAPHIX (877) 928-7351
LOOSE -FILL
INSULATION CERTIFICATE
Date Installed
GALE CONTRACTOR SERVICES, INC.
5414 E. Broadway, Suite B
Spokane, WA 99212
Contractors #GALECS*988DN
PART 4 CERTIFICATION
Servs in Part 1 was insulated as specified in Part 2, or 3 and the installation was
GALE Contractor Services certifies that the above residence iderrtitied
conducted in conformance to applicable codes, standards and regulations at the time of installation -
1 .
(AVIP
ORIZED SIGNATURE)
WHITE COPY TO CUSTOMER • YELLOW C1WY TO UTILITY • PINK COPY TO CONTRACTOR • HARD COPY TO ATTIC