2003, 08-29 Permit App: BLD-03-02353 Piping 3 t � a 11707 East Sprague A vent ,Suite 106 509-688-0036-Phone
►r�pOne Spokane Valley,WA 99206 509-688-0037-Fax
,,,,,.*Valley
Mechanical Permit Application
PROJECT /3/2- A(`‘. t( [. t 1— (7 J, PERMIT
ADDRESS:S ,�, "„).c Oce llc y
C19?d 4O USE:
OWNER J/� CD,--d PHONE(Daytime Contact):
MAILING!ADDRESS:
Po. l?O X 1%/4345' .S7.,c)ko Ne dro (v 400- l 9;,1/17/
(street) (city/state) / (ZIP)
CONTRACTOR: LICENSE#:
0 Well ter-
MAILING ADDRESS: PHONE#:
5°9) 924'-/767
(street) (city/state) (ZIP)
DESCRIPTION OF WORK 8 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 )( S50 -
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) - / X $1 = /,D a
18 DUCT SYSTEMS - X $10 =
19 VENTILATING FANS - X $10 =
20 AIR HANDLER(DOES NOT indude 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:
METHOD OF PAYMENT PLUS PROCESSING FEE: $35.00
Mini
';� TOTAL PERMIT FEE DUE:
VISA' •® CASH ❑ CHECK ❑ MN= ❑ t____...:,:. '
.___... '_
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: