2003, 05-23 Permit App: BD03-503 Vent Fan QUTI c !il U 11 ,, 11707 East Sprague Avenue, Suite 106 509-688-0036-Phone
1 � ne Spokane Valley,WA 99206 509-688-0037-Fax
.Valley For Inspections, call 509-688-0054
Mechanical Permit Application E Q 403-503
PROJECT / 1/44)9,4144 PSE: (t� (-,T il V 1
ADDRESS: / 5-9/6 �^ , USE:
OWNER Ly 0-4 n v(7 PHONE(Daytime Contact):
MAILING ADDRESS:
I S`?it E- 14-4 8 R- 'Ii Seb -yl /4-//:#7 tt4-- 9' I6
(street) ,,, (city/state) (ZIP)
CONTRACTOR: / /`� L'v��� `17 LICENSE#: r/�/�®CC'`$_ 2/Q
MAILING ADDRESS: G e PHONE#: 5-a 1 I 5-3 //4 ? p
Si°&�yz 4r 11 9-1 -
(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 I-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 =
16 MISC FUEL BURNING APPL. - X $10 -
17 GAS PIPING(ea.Outlet) - X $1 =
18 DUCT SYSTEMS - X $10 -
19' ENTILATING FANS - / X $10 - 10-.0.49C)
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: /D .6D
METHOD OF PAYMENT PLUS PROCESSING FEE: $35.00
li" tG TOTAL PERMIT FEE DUE: �5�m
❑ CASH ❑ CHECK ❑ Ma= ❑ __'
DATE: /�`� EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: ',.„,„r,+�. -�,�;;_-