2003, 10-02 Permit App: BLD-03-02655 Mechanical Fixtures Scrrr t )0011"111111\12%,„ 11707 East Sprague Avenue,Suite 106 509-688-0036-Phone
PO-BaneSpokane Valley,WA 99206 509-688-0037-Fax
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Mechanical Permit Application
PROJECT (-74PERMIT
ADDRESS: / ,v G L v i pp A., USE:
OWNER: 0 i'// PHONE(Daytime Contact):
MAILING ADDRESS:
(street) (city/state) (ZIP)
CONTRACTOR:. LICENSE#:
MAILING ADDRESS: -' PHONE#:
_ 12',Oil,�c 1/11 41,4 9902/7
(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 S50 -
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
16 MISC FUEL BURNING APPL. - X $10 -
17 GAS PIPING(ea.Outlet) - i 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 i 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 5255 =
SUBTOTAL:
METHOD OF PAYMENT PLUS PROCESSING FEE: $35.00
VISA' • jvwSt f''-;: TOTAL PERMIT FEE DUE:
❑ CASH ❑ CHECK ❑ 1111111111 ❑ I ._.._'_ }
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: