2005, 10-19 Permit App: 05003905 Mechanical Fixtures CSS
FEB 17 2004 14:48 FR TO 9266890 P.01i01 48 _____
Y . ____
11707 East Sprague Avenue,Suite 106 509-688-0036-Phone
e Spokane Valley,WA 99206 509-688-0037-Fax
For Inspections, call 509-688-0054
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-Mechanical Permit Application
PROJECT
ADDRESS: / Z / its. UN l()girl YgPEPERMIT[X ^G Cf S F;;,ee F D o t:JLLC'4e-
. OWN!?R: 0 kg_ 39`Cl o'f t '-�J PHONE(Daytime Contact): S33-3-77.2.,
MAILING ADDRESS:
1/4-1 to i��, f ow ►^aL SF, v oo L.: uu ck.- 9 9 Zo LL
(street)
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CONTRACTOR: C d ll.f .tI i;i. cV i C el t-
LICENSE:: C 0 04 0 ell, E;0 :3`3 K
MAILING ADDRESS: PHONE 1: CtZg
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PO 3 ole i S, G r4 ehc Cr 12 w at.- 9 (LO i el. i
(street) (city/state) (ZIP) i
DESCRIPTION OFWORK SOFLIIVITS X COST EQUALS AMOUNT
. 1 FUEL BURNING APPLIANCE -OR 4100,000 X 515 - A
2 FUEL BURNING APPLIANCE ,100,000 X 319 -
3 UNLISTED APPLIANCE(ADDITIONAL PHP) ■OR c 400,D10 X $30 -
4 UNLISTED APPLIANCE(ADDrfor4AL FEE) s 400,000 _ X 9100 •
5 USED APPLIANCE(WSEC man APUE gaunt) -ort 400.000 X 550 -
6 USED APPLIANCE(WSEC min APUE rating) )400,000 X 7100 1 -
y
Y POILER/REPRIGERATION 1-100M ETU X $13 •
6 BOILER/RFPRIGERATzON 101-500M BTU X $28 •
9 BOILER/REFRIGERATION 701.1,000M BTU X $39 -
10 BOILER/REFRIGERATION 1001.1,750M BTU X E57 •
11 BOILER/REFRIGERATION 47505i BTU X 595 -
12 GAS IDG,GAS INSERT GAS Fat2PU.CE - X ' $10 •
13 RANGE - X 510 -
14 DRYER - X $10 -
15 FUEL.BURNING WATER HEATER - ` X $10 -
14 MISC,FUEL BURNING APPS., -- X 510 •
17 CAS PIPING(m Outlet) - r X El - 7 ego
18 DUCT SYSTEMS - X $10 -
19 VENTILATING PANS , X 110 - -•20 AIR HANDLER(DOES NOT mdude snodi g) •OR 410,000CFM X $12 -
21 Alli HANDLER(DOES NOT induct*dtuBn5) a 10,000 CFM X $19 -
22 EVAPORATIVE ODOLERS - X 110 ■
23 TYPE 114000 .__. - X L Oso -
TYPE II HOOD ----, - X 510 -
25 HEAT PUMPIAIRCONDITIONER 0-3 TON X $12
21 AIR COND171ONBR 315 TON X 920 -
. 27 AIR CONDITIONER 15-3D TON X S25
2$ AIR CONDITIONER 3050 TON X S35 -
29 AIRCONOITIONER 40 TON X Seo ■
30 LPG STORAGE TANK - X $10 -
31 WOOD OR PELLET STOVE/INSERT - - X $10 - -
31 WOOD STOVE-FREE STANDING - X 32s ■
SUBTOTAL I LL
METHOD OF PAYMENT PLUS PROCESSING PEE: $35.00
mss: 1 TOTAL PERMIT FEE DUE: (5 / 00
❑ CASH 0 CHECK 0 111111111111111 0 k-- -
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
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