2004, 11-18 Permit App: BLD-04-08141 Mechanical Fixtures ary t 01111"\111%, 11707 East Sprague Avenue,Suite 106 509-688-0036-Phone
ptiii.anee Spokane Valley,WA 99206 509-688-0037-Fax
For Inspections, call 509-688-0054
,r,,. Valley
'Mechanical Permit Application
PROJECT
ADDRESS: /c /j / USE: q
OWNEI�'s�-� _ _ (V"ez PHONE(Daytime Contact): q 2.(�_ 7 i 2
MAILING ADDRESS:
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(street) (city/state) (ZIP)
CONTRACTOR: LICENSE#: SMITHHC080R8
SMITH HEATING & COOLING. INC.
MAILING ADDRESS: PHONE#: 328-4431 FAX: 328-0749
E. 102 NORA SPOKANE WA 99207
(street) (city/state) (ZIP)
DESCRIPTION OF WORK 8 OF UNITS X COST EQUALS AMOUNT
1 FUEL BURNING APPLIANCE -OR<100,000 / X $15 - /5-1070
2 FUEL BURNING APPLIANCE >100,000 X $19 -
3 UNLISTED APPLIANCE(ADDITIONAL FEE) -OR<400,000 X $50 •
4 UNLISTED APPLIANCE(ADDMONAL 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) - X X $1 - /1 b C
18 DUCT SYSTEMS - ( X $10 - /00'07;)
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 -
26 AIR CONDITIONER 3-15 TON X $20 -
27 AIR CONDITIONER 15-30 TON X $25 -
28 AIR CONDMONER 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: o/k) O 0
METHOD OF PAYMENT PLUS PROCESSING FEE: $35.00
MOMS 1}�, 4 . i TOTAL PERMIT FEE DUO 4, / 0 D
❑ CASH ] CHECK ❑ ❑ :__. .._} ,_ I
, — off
DATE: //—I 017Z EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: