2003, 11-07 Permit App: BLD-03-03029 Gas Log, Piping i1 -' ', 1 FF' TO c:-42231 1E-: F'.02 1_ 3
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MECHANICAL PERMIT APPLICATION
'PERMIT
PROJECT PER:
ADDRESS: S . �7 0 IAA-IL C — PHONE(Daytime Contact):
OWNER: o�,.y _
MAILING ADDRES : Ss10 ` V, • i f' 1"0 ar 37
street ci /stet. I zi• _
CONTRACTOR: LICENSE*: ANDERSM15 8NZ i
ANDERSON' S SHEET METAL HEATING & A.C. f
MAILING ADDRESS: PHONE*: ( 5 0 9 ) 928-0960 -D `
E. 13903 Trent Ave. - jj, J
Spokane Valley, Washington 99216 `�
(- -
(street) _.... _ .
(citylstatez
DESCRIPTION OF WORK #or WHITS X COST EQUALS AMOUNT
1 FUEL BURNING APPLIANCE =OR4100,000 X $15 = -,
X $19 =
2 FUEL BURNING APPLIANCE >100,000
3 UNLISTED APPLIANCE(ADDITIONAL FEE) =0R<400,000 X $50 =
4 UNLISTED APPLIANCE(ADDITIONAL FEE) X400,000 X $100 _
5 USED APPUANCE(WSEC min.AFUE rating) OR<4R<400,000 X $50 ..000 X $100 -
t3 USED APPLIANCE SEC min,AFUE rating) X $15 =
7 BOILER/REFRIGERATION 1-100M BTU .-
101-500M BTU X $28 =
8 BOILER/REFRIGERATION X $39 ■
9 BOILER/REFRIGERATION 5o1.1,000M BTU _
10 BOILER/REFRIG_ERRATION 1001-1,750M BTU _ X $57
111 BOILERJREFRIGERATION +1750M BTU X $95
12 GAS LOG,GAS INSERT,GAS FIREPLACE - / X $10 ■ _ to, CID
X $10
13 RANGE _ - - 1 X $10
14 DRYER -• 1 ""X $10 ■
15 FUEL BURNING WATER HEATER - X $10- .,16'MISCELLANEOUS FUEL BURNING APPL -
17 GAS PIPING(ea.Outlet) - X , $1 - I. ON)
X $10 ■
18 DUCT SYS 11=MS ' X $10 =
19 VENTILATING FANS - X $12 =X $19
' 20,AIR HANDLER(DOES NOT include ducting) =OR<10,000CFM _
21 AIR HANDLER(DOES NOT indude ducting) >10,000CFM ■ -..
22 EVAPORATIVE COOLERS - I `"X $10 ■
23 TYPE I HOOD - X $50 -
24 TYPE It HOOD - _ X 310 - _
X• $12 ■
25 HEAT PUMP/AIR CONDITIONER 0-3 TON _ X $12
26 AIR CONDITIONER 3-15 TON 20 4 —
15-30 TON X $25 ■
27 AIR CONDITIONER _ X S35 ■
28 AIR CONDITIONER 30-50 TON
29 AIR CONDITIONER +50TON X $80 __
30 LPG STORAGE TANK - X $10 :.
-_
WOOD OR PELLET STOVE/INSERT - — X $10 = ,
32 WOOD STOVE-FREE STANDING - X $25
_. _ • __ _� SUBTOTAL , /' �+
❑ CA SH CHECK ❑ Mann v [2] ` '='`'-! PLUS PROCESSING ..__�
$35.00
PAXFD PF-R?"!ITS W7LL ONLY BE ACCEPTED will;PAYMENT FEE
OF.1 M1iOP,c...kEDIT CkRD __-..r-..
TOTAL PERMIT FEE if � rp
DUE �
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