2005, 05-20 Permit App: 05001717 Mechanical Fixtures r-lcrr v t /'mo Niarao, 11707 East Sprague Avenue, Suite 106 509-688-0036-Phone
PCOliarie Spokane Valley,WA 99206 . �, 509-688-0037-Fax
4.00 Valley
•Mechanical Permit Application
PROJECT PERMIT
ADDRESS: 5 clr 5 9 Ay, USE:
OWNER: j�I �t/N./ PHONE(Daytime Contact): ;.•5-- t8 .J z.-9MAILING ADDRESS: /�^ /
(street) (city/state) (ZIP)
CONTRACTOR/ t d e�4 J1it A�2_ c `v PHONE �
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MAILING ADDRESS: am° 210 9 6! -r /0 ! Vr
,41770 f . (2.- G.1,1- .7) 0 R I y
(street) (city/state) (ZIP)
DESCRIPTION OF WORK F 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 5100
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 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 $95 -
12 GAS LOG,GAS INSERT,GAS FIREPLACE - X 510 - •
13 RANGE - X 510 -
14 DRYER - X $10 -
15 FUEL BURNING WATER HEATER - X $10 - 1 t0,
16 MISC.FUEL BURNING APPL. • - X $10 -
17 CAS 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 HOOD - X 550 -
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
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
• VISA'. • :54'skvc.. .
TOTAL PERMIT FEE DUE:
❑ CASH ❑ CHECK ❑ Mini= ❑ -----`--—
DATE: ' EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: