2004, 02-20 Permit App: BLD-04-03591 Mechanical Fixtures r-ron t 11707 East Sprague Avenue,Suite 106 509-688-0036-Phone
poliane Spokane Valley,WA 99206 509-688-0037-Fax
Walley For Inspections, call 509-688-0054
'Mechanical Permit Application
PROJECT PERMIT
ADDRESS: 131-(7zt- G 12+lb Sp_.. USE:
OWNER: W r-N 1 Dy (\(1 A ,V f l I c PHONE(Daytime Contact): Q,C_ DQ1,0S
MAILING ADDRESS: I I Y [
13104 S 124 CPD KANE WA '12 f to
(street) (city/state) (ZIP)
CONTRACTOR: "12 - MFD/2-7--
01 LICENSE II:
MAILING ADDRESS: PHONE#: 3.7 . 4439,1..
(street) (city/state) (ZIP)
DESCRIPTION OF WORK 8 OF UNITS X COST EQUALS AMOUNT
1 FUEL BURNING APPLIANCE =OR<100,000 1 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 =
B 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 — IX $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) — a 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 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 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:
METHOD OF PAYMENT PLUS PROCESSING FEE: $35.00
i TOTAL PERMIT FEE DUE: TN Ul l
VISA' I ` v�
0 CASH 0 CHECK 0 0 i____-__'.'L'±._
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: