2004, 09-27 Permit App: BLD-04-07775 Water Heater Soart I +/r" `rM 11707 East Sprague Avenue,Suite 106 509-688-0036-Phone
ne Spokane Valley,WA 99206 -. 509-688-0037-Fax
.000Valley
•Mechanical Permit Application
•
PROJECT PERMIT
ADDRESS: e oty,. -geoze USE:
OWNER' 30 t/ - /0.A lj• _ ��/ HONE(Daytime Contact): f iQ36�
MAILING ADDRESS: r GC.�(,/1�'�` rr/ / �/
(street) (city/state) (ZIP)
CONTRACTOR/ rte c t r LICENSZ 3Gs ?g `7 /
MAILING ADDRESS: r/ PHONE# 7
.2o2 6.6 06c1 p
(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 - X $10 - • •
13 RANGE - X $10 -
14 DRYER - X $10 - .
15 FUEL BURNING WATER HEATER - X $10 . JO, -
16 MISC FUEL BURNING APPL • - X $10 -
17 GAS PIPING(ea.Outlet) - X $1 - •
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 Include 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: A, W
METHOD OF PAYMENT . • PLUS PROCESSING FEE: $35.00
iiiiii ;t'2f - TOTAL PERMIT FEE DUE:
• YlS+4 ..• .
❑ CASH CHECK El ININNI El — -. s
DATE: ' EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: