2003, 04-08 Permit App: BD03-053 Hot Water Heater at 11707 East Sprague Avenue,Suite 106 509-688-0036-Phone
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PROJECT / PERMTt.�wa („l"j G f kl f„ �i t
ADDRESS: /0 G)Z/ 6i 16 USE: �I vV l '`YV
OWNER: ..1 _9_„ PHONE(Daytime Contact): iD z�
MAILING ADDRESS: ���'�
(street) (city/state) (ZIP)
CONTRACTOR: / 10 �`''� LICENSE#: -5 e- S 9 /
MAILING ADDRESS: t PHONE#:
Z()S 6:G V 06449
6 7X /`- CPA- , --,v ' ? ' V
(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 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 - X $10 =
13 RANGE -- X $10 =
14 DRYER - X $10 =
15 FUEL BURNING WATER HEATER - X $10 = /0
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 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
MEM
VISA' - t� .,- TOTAL PERMIT FEE DUE: LS,<3C}
❑ CASH ❑ CHECK ❑ MIME ❑ L___.__.!'`=
DATE: EXPIRES:
BANKCARD NUMBER:
AUTI-IORIZED SIGNATURE: