2005, 01-28 Permit App: 05000270 RangeSlane
4#Valley
Mechanical Permit Application
1170 Eat Sprague Avenue, Suite 106 509-688-0036 - Phone
Sp6ane Valley, WA 99206
509-688-0037 - Fax
or -27D
-- 1'CKIYII
ADDRESS: '/ USE:
i .. A.I
.1 -
.
OWNER PHONE (Daytime Contact):
iJa L r i a ON
9�8__ Srfr
MAILING ADDRESS:
/
AMOUNT
1
FUEL B LIMING APPLIANCE
(street) (city/state)
(ZIP)
X
515
CONTRACTOR: AlInge4,LICEN.. t:
2
FUEL BURNING APPLIANCE
MAILING ADDRESS: PHONE t:
I
r b
r
-
3
UNLLSTEDAPPLIAKCE(ADDITIONAL FEE)
(street) (city/state)
(ZIP)
X
550
-
4
UNLISTED APPLIANCE (ADDITIONAL FEE)
METHOD OF PAY
❑ CASH ail
DATE:'
a U L-±tl.rrr,-1
EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DF{SCRIPTION OF WORK
1 OF UNITS
X
COST
EQUALS
AMOUNT
1
FUEL B LIMING APPLIANCE
-OR<103,000
X
515
-
2
FUEL BURNING APPLIANCE
> 100,000,
-
X
519
-
3
UNLLSTEDAPPLIAKCE(ADDITIONAL FEE)
-OR<400,030
X
550
-
4
UNLISTED APPLIANCE (ADDITIONAL FEE)
>400,000
X
4100
-.
5
USED APPLIANCE (WSEC Mn AFUE rating)
- or <400,000
'X
550
-
6
USED APPLIANCE (WSEC min AFUE rating)
>400,003
X
5100
-
7
BOILER/REFRIGERATION
1 .100M BTU
X
515
8
BOILER/REFRIGERATION
101- 500M BTU
X
528
-
9
BOILER/REFRIGERATION
501 - 1,000M BTU
X
539
-
10
BORER/REFRIGERATION
1001- 1,75084 BTU
X
557
•
11
BOILIR/REFRICERATION
+1750M BTU
X
595
-
Y2
GAS LOG, GAS INSERT, GAS FIREPLACE
-
X
'510
•
13
RANGE
-
X
510
-
rr
/61,
14
DRYER
-
X
510
-
15
FUEL BURNING WATER HEATER
-
X
510
•
16
MISC FUEL BURNING APPL
-
X
510
-
17
GAS PIPING (et Outlet)
-
X
51
-
18
DUCT SYSTEMS
-
X
510
-
19
VENTILATING FANS
-
X
510
-
20
AIR HANDLER (DOES NOT Include ducting)
- OR< 10,000CFM
X
512
•
21
N
AIR HANDLER (DOES NOT Includedung)
>10,000 CFM
X
519
-
'22
EVAPORATIVE COOLERS
-
X
510
•
23
TYPE I HOOD
-
X
$50
•
24
TYPED HOOD -
-
X-
510
•
25
HEAT PUMP/AIR CONDITIONER '
0-3 TON
X
512
-
26
AIR CONDITIONER
3-15 TON
-
X
520
•
27
AIRCONDMONER
15-30 TON
X '
525
-
28
AIR CONDITIONER
30.50 TOn/
X
535
•
29
AIR CONDITIONER
+50 TON
X
560'
-
30
LPG STORAGE TANK
-
X
510
-
31
WOOD OR PELLETSTOVE/INSER-F -
-
X
510
•
32
WOOD STOVE -FREESTANDING
-
X
525
a
BENT :
-_ .--. east._'Tk!E
SUBTOTAL:
PLUS PROCESSING FEE:
$35.00
TOTAL PERMIT FEE DU'
a U L-±tl.rrr,-1
EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: