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2004, 01-16 Permit App: BLD-04-03417 Insert SOTT Ws 411.1"1\1841111%. 11707 East Sprague Avenue,Suite 106 509-688-0036-Phone pokane Spokane Valley,WA 99206 509-688-0037-Fax 4.0.0Vallq For Inspections, call 509-688-0054 Mechanical Permit Application PROJECT 1 i (� PERMIT 0 ADDR / 7/l (�(�/�LUA USE: f, 14--,( t 5/ I_ Le- OWNER (� PHON (Da time ntact: MAILIN DDRESS: 6 /&it5 4/ %VOOA4Y 1/ evAq o5 7 (street) (city/state) (ZIP) CONTRACTOR: LICENSE#: MAILING ADDRESS: PHONE#: (street) (city/state) (ZIP) 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 = 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 = 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 ,L?C X $10 > (Q 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 e- 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 indude 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 I I " . �� VISA . 41-44.1,-,-r h TOTAL PERMIT FEE DUE L�b,I/t l ❑ CASH ❑ CHECK ❑ ❑ '_-._.--__.= / 1/` , DATE: _ EXPIRES: BANKCARD NUMBER: AUTHORIZED SIGNATURE: