2003, 10-09 Permit App: BLD-03-02724 Mechanical Fixtures SCITY c 011"\1411111114k 11707 East Sprague Avenue,Suite 106 509-688-0036-Phone
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PO- .ile Spokane Valley,WA 99206 509-688-0037-Fax
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Mechanical Permit Application
PROJECT / / PERMIT g,�/��, /
ADDRESS: / <1 $ Z� /��piz, s, J USE �G4 Cif k (' dd. �.eZ W
OWNER: i-t /CN.e,�?(... . ,V PHONE(Daytime Contact): ` •
MAILING ADDR SS: /
(street) (city/state) (ZIP)
CONTRA l c- 4 /4`' LICENSE#: �E/1/9 D$ e ///.1
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(street) (city/state) (ZIP)
DESCRIPTION OF WORK #OF UNITS X COST EQUALS AMOUNT
1 FUEL BURNING APPLIANCE =OR<100,000 /r ' X $IS / c'"---G'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 i Q s94✓
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) - Z X $1 ? 't. S
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 12 CEJ
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
MONVi A . Vast t^:,' TOTAL PERMIT FEE DUE (9 t�
El CASH ❑ CHECK ❑ ElI - ' .
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: