2005, 01-31 Permit App: 05000281 Mechanical Fixtures Sare c 11707 East Sprague Avenue,Suite 106 509-688-0036-Phone
po)Iiane Spokane Valley,WA 99206 509-688-0037-Fax
... .*Valley For Ilnspections, call 509-688-0054
'Mechanical Permit Application ()' � ��� i
PROJECT PERMIT
ADDRESS: r p USE:
OWNER C L1 F��/ U/F f i...-0(L /+ PHONE(Daytime Contact): •7 G c ,- c7 hl 1
MAILING ADDRESS:
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(streef (city/state) (ZIP)
CONTRACTOR:1126 e /►f N�L yrj_} LICENSE#:
MAILING ADDRESS: C- J` // ✓ PHONE#:
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DESCRIPTION OF WORK It OF UNITS X CDST EQUALS AMOUNT
1 FUEL BURNING APPLIANCE -OR<100,000 A X - C" - IJ
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 = /0
16 MISC.FUEL BURNING APPL. - X $10 -
17 GAS PIPING(ea.Outlet) - X $1 - j c 1-6
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 CONDmONER 0-3 TON X $12 -
26 AIR CONDITIONER 3-15 TON
/ X $20 - 0
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: (.l i
5
METHOD OF PAYMENT PLUS PROCESSING FEE: $35.00
mom I
i 44B-earnkr TOTAL PERMIT FEE DUE: --- 6
❑ CASH ❑ CHECK ❑ ❑ ' .-.__._ , I C(
DATE: EXPIRES:
BANKCARD NUMBER
AUTHORIZED SIGNATURE: