2004, 10-18 Permit App: BLD-04-07954 Hot Water Heater aTt(Iry 11707 East Sprague Avenue,Suite 106 509-688-0036-Phone
t .. plane Spokane Valley,WA 99206 509-688-0037-Fax
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•Mechanical Permit Application
PROJECT PERMIT
ADDRESS: 7 .6;;P fp*
C.ett-Q-1 USE:
OWNER:
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MAILING ADDRESS:
(street) (city/state) (ZIP)
CONTRACTOR:/ t_ c nr LICENSE#: CG. ,O p 4(
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MAILING ADDRESS: PHONE#: 7 9 7
(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 APPLIANtE(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 +17501v1 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 le 4�
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16 MISC.FUEL BURNING APPL. - X $10 -
17 GAS PIPING(ea.Outlet) - X $1 - •
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 HOOQ - 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 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: Jo QO
METHOD OF PAYMENT PLUS PROCESSING FEE: $35.00
reast . TOTAL PERMIT FEE DUE: V 5;04
❑ CASH ❑ CHECK ❑ ❑ :._
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: