2003, 06-12 Permit App: BD03-598 Piping iCTe t rrr1k 11707 East Sprague Avenue,Suite 106 509-688-0036-Phone
po�.l :e Spokane Valley,WA 99206 509-688-0037-Fax
....*Valley: For Inspections, call 509-688-0054
Mechanical Permit Application
PROJECT PERMIT
ADDRESS: (774/ E• ott USE: B0 - a 3 • 5-9Y
OWNER E.w 3 ','.44-i1
PHONE(Daytime Contact): 9 /-7927
MAILING ADDRESS: Fi
972/ E. 03'1 5411ri9vtiE lelig 99z.o4
(street) (city/state) (ZIP)
CONTRACTOR: LICENSE#:
MAILING ADDRESS: PHONE#:
(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 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) - iX $l - 5/.0105 1' ' i✓'
18 DUCT SYSTEMS - X $10 =
19 VENTILATING FANS - X $10 = ,/) , -0
20 AIR HANDLER(DOES NOT include ducting) -OR<10,000CFM X $12 - /�/-/[
21 AIR HANDLER(DOES NOT indude ducting) >10,000 CFM X $19 = '/
•
22 EVAPORATIVE COOLERS - X $$1050 �/'�`/�
23 TYPE I HOOD - X S50 `T
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: 3`,p p
METHOD OF PAYMENT PLUS PROCESSING FEE: $35.00
iiiiiiiii : TOTAL PERMIT FEE DUE:
VISA • i'sz ' 36,fA
❑ CASH ❑ CHECK ❑ ❑ i-- .__ -.
•
DATE: L -12. "0 3 EXPIRES: p
A u
oD
BANKCARD NUMBER
AUTHORIZED SIGNATURE: