2003, 10-10 Permit App: BLD-03-02730 Inserts, Piping ScrrY t 11707 East SpTaguejAvenue,Suite 106 509-688=0036-Phone
po kine Spokane Valley,WA 99206 509-688-0037-Fax
Mechanical Permit Application
PROJECTPERMIT
ADDRESS: I'3On E- T AVS - USE:
OWNER: p —1al 1
mQ�YYI (ZV ET H PHONE(Daytime Contact): C
MAILING ADDRESS:
(street) (city/state) (ZIP)
CONTRACTORCti• LICENSE It:
I
A ,"N SiLVE
MAILING ADDRESS: - PHONE It:
(street) (city/state) (ZIP)
DESCRIPTION OF WORK #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 - 'Z• X $10 Z..0
13 RANGE - X $10 -
14 DRYER - X $10 =
15 FUEL BURNING WATER HEATER - - X $10 -
16 MISC FUEL BURNING ADPL. - - X - $10 -.
17 GAS PIPING(ea.Outlet) - Z X $1 - Z,
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: 22
METHOD OF PAYMENT PLUS PROCESSING FEE: $35.00
t TOTAL PERMIT FEE DUE 5i
❑ CASH ❑ CHECK ❑ MOM ❑ 1_ __7_
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: