2003, 09-26 Permit App: BLD-03-02595 Jeweler's Torch, PipingSp"okane
.0,,•�Valley
11707 E. Sprague Ave., Suite 106
Spokane Valley, WA 99206
Job Address: 10212 E VALLEY WAY
SPOKANE WA 99212
Description: GAS JEWELER'S TORCH AND PIPING
Subdivision: Lot:
Owner:
Applicant:
Address:
Contractor:
Address:
CARR, PATRICIA L
GOLD SEAL SERVICE
5524 E BOONE AVE
SPOKANE, WA 99212-0903
GOLD SEAL SERVICE
5524 E BOONE AVE
SPOKANE WA 99212-0903
MECHANICAL
Bl k:
Phone:
Phone:
Lic No:
THIS IS NOT A PERMIT
Penalties will be assessed for
commencing work without a permit
Application #:
Applied:
Issued:
Expires:
Parcel No: 45174.2508
(509) 535-5946
(509) 535-5946
GOLDSS*133QS
BLD -03-02595
Zoning:
09/26/2003
09/26/2003
03/24/2004
General Information:
SUPPLEMENTAL PERMIT
FUEL BURNING APPL <= 100,000
UNLISTED APPLIANCE <= 400,000
GAS PIPING (ea. OUTLET)
N
1
1
1
Fees:
MECHANICAL PROCESSING FEE
FUEL BURNING APPL <= 100,000
UNLISTED APPLIANCE <= 400,000
GAS PIPING
Total Calculated:
Deposits/Receipts:
Total Due:
35.00
15.00
50.00
1.00
101.00
0.00
101.00
Cakar-1_01c (At
r Cuiv
THIS IS NOT A RECEIPT
SEP 14 2003 00:45 FR
TO 5359359
r . UG." U-)
APPLICATION FOR GAS APPLIANCE
e AND EQUIPMENT APPROVAL
(Not approved or listed by a recognized listing agency.)
11707 E Sprague Ave Suite 106 ♦ Spokane Valley WA 99206
509.921.1000 + Fax: 509.921.1008 ♦ cityhall@spokanevalley.org
Address: 1 Oat h,:4 1
Appliance: 71- C L./
Owner: Tz-ez
Installing Company: 4-0--ed-
Date:
Date_ 20 0 3 Project No.:
All gas appliances and accessories installed for domestic.o:: commercial use slxall. comply .with, and to be of a
design and construction compatible with, applicable "xtr,erican Stindatd Approval, Listing and Installation
requirements of the American Standards Association, Inc". Listed accessories and controls on industrial and
other specialized appliances and equipment not included in the above requirements of the "1�Irerican
Standards Association Inc.", may be installed upon approval by the Building Official, Each appliance shall be
marked or labeled with a distinctive trademark or name as means of identification showing the rated heat
input in BT.U_ per hour. la ad case skull au appliance be fired or adjusted to pass a greater amount of gas
than rated capacity.
The undersigned hereby requests that an inspection be made fox thc following equipment as described below!
!application filed by-
Address:
Telephone: ff
1. Name of appliance or accessory: 'Te it.) eier5 `�' t-) Model No-
2. Trade Namc_ •SAM 1N1t0 r El New " Used
3. Type of burner or appliance:
4. Construction ofheating clement: 8015>
5. Name and address of manufacturet:
6. Type of fuel recornmeraded fox burner. 1✓ g [L? /JL 645
7. Length of time burner has been on market:
8- Nfaximmn burner rating, manufacturer's recommended manifold pressure and orifice size;
9. Vent requirements and recommendations by the manufactures:
1
10. Type of vent required:
22 -110101 -App for Gas Appliance
SEP 14 2003 03: 45 FR
TO 5359359 r•u.s/uo
`.o
11. Stack temperature at maximum firing sate:
12. Recommended clearance to combustible 1nawtial, including combustible floor: mounting:
13. Remarks or description:
14. Please enclose complete installation and operating instructions.
15. Furnish engineering data, descriptive material showing construction details included controls and
wiring diagram. (Note: Plans for installations over 400,000 BTU must be reviewed and stamped by
a licensed Mechanical Engineer)
16. Attach blueprint of assembly drawing showing construction device indicating gas and air passages
and control layout.
Reviewed by-. .j/
D
22 -110101 -App for Gas Appliance
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