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2003 Permit App: BD-03-279 3 OTY( !� '�a,�, 11707 East Sprague Avenue,Suite 106 509-688-0036-Phone ne Spokane Valley,WA 99206 509-688-0037-Fax sValleY For Inspections, call 509-688-0054 41•001 Mechanical Permit Application `8 D £3 -279 PROJECTPERMIT /' ADDRESS: �j /" USE: //U OWNER /� (I( /I x� �/ �'/ '4 LeV/� PHONE(Daytime Contact): 3 2-/c 7 fi ' MAILING ADDRESS: p O `c3P2l/ C.5: c_52'%,4 4. --5.,e- lia• 97Cfr (street) (city/state) (7TP) CONTRACTOR: d zdide LICENSE#: MAILING ADDRESS: PHONE#: (street) (city/state) (ZIP) DESCRIPTION OF WORK 9 OF LINJTS X COST EQUALS AMOUNT I FUEL BURNING APPLIANCE =OR<100,000 / X' 515 f 5'-&U 2 FUEL BURNING APPLIANCE >100,000 X 519 = 3 UNLISTED APPLIANCE(ADDITIONAL FEE) =OR<400,000 X 550 = 4 UNLISTED APPLIANCE(ADDITIONAL FEE) >400,000 X 5100 = 5 USED APPLIANCE(WSEC min.AFUE rating) =or<400,000 X 550 = 6 USED APPLIANCE(WSEC min.AFUE rating) >400,000 X 5100 = 7 BOILER/REFRIGERATION 1-100M BTU X $15 - 8 BOILER/REFRIGERATION 101-500M BTU X 528 - 9 BOILER/REFRIGERATION 501-1,000M BTU X $39 = 10 BOILER/REFRIGERATION 1001-1,750M BTU X $57 = 11 BOILER/REFRIGERATION +1750M BTU X 595 - 12 GAS LOG,GAS INSERT,GAS FIREPLACE — Z X $10 = 20, 13 RANGE __ 14 DRYER / X 510 = i r) X 510 = 15 FUEL BURNING WATER HEATER — / 0/l $10 {° 16 MISC.FUEL BURNING ADPL. — X $10 17 GAS PIPING(ea.Outlet) — C� $1 = 5--- 18 DUCT SYSTEMS — $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 519 = 22 EVAPORATIVE COOLERS — X $10 = 23 TYPE I HOOD — X 550 = 24 TYPE II HOOD — X 510 - 25 HEAT PUMP/AIR CONDITIONER 0-3 TON X $12 12 26 AIR CONDITIONER 3-15 TON X $20 = 27 AIR CONDITIONER 15-30 TON X $25 = 28 AIR CONDITIONER 30-50 TON X 535 = 29 AIR CONDITIONER +50 TON X 560 = 30 LPG STORAGE TANK — X $10 - 31 WOOD OR PELLET STOVE/INSERT — X 510 = 32 WOOD STOVE-FREE STANDING — X $25 - • SUBTOTAL: -7 .0) METHOD OF PAYMENT PLUS PROCESSING FEE: $35.00 VISA re: • TOTAL PERMIT FEE DUE: ro 0 V ❑ CASH ❑ CHECK ❑ ❑ -_ '.`..I 7 v V % 0 DATE: EXPIRES: li) BANKCARD NUMBER: 1 \1- AUTHORIZED SIGNATURE: