2004, 03-25 Permit App: BLD-04-03893 Sewer OCT 17 2003 11 39 FR TO 9223118 P.01/02
STrr -11707 East Sprague Avenue,Suite 106
509-688-0036-Phone
rie Spokane Valley,WA 99206 509-688-0037-Fax
4.0,00Valley For Inspections, call 509-688--0054
-Mechanical Permit Application
PROJECT PERMIT
ADDRESS: 6''. / O 7 O'/-- .0 USE:
pWNER / r F � PHONE(Daytime Contact): cfa7 _/,2��
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MAILING AD ESS: p
E• /070 f— 02044 s ok R V4r.Q-�.., )W&, it ! �'l��p.
(sheet) (dt�state) U (ZIP)
CONTRACTOR:75A/DER SON i- -SA-6-7- /H er/I c LICENSE s: /I��E/e sm f.ce IV.Z
MAILING ADDRESS: PHONE I:
E. 13903 %S6-NT I - 0r67,
St 0/r AJE Vii-u.6 y con • 772/6
(street) (city/state) (ZIP) .
DESCRIPTION OF WORK 0 OF UNIS X C057 EQUALS AMOUNT
1 FUEL BURNING APPLIANCE -OR<100,000 J X $15 - /.5-. 5
2 FUEL BURNING APPLIANCE >100,000 X $19 -
_
3 UNLISTED APPLIANCE(ADDITIONAL FEE) -OR<400,000X S50 -
!
4 UNLISTED APPLIANCE(ADOMONAL FEE) >400.000 X 5100 - -
S USED APPLIANCE(WSEC min.AFUE rating) a or<400.000 X .. $50 -
6 USED APPLIANCE(WSEC min.AFUE rating) >600.000 X $100 -
7 BOILER/REFRIGERATION 1-100M BTU X $13 -
8 BOILER/REFRIGERATION 101-500M BTU 'X S28 -
9 BOILER/REFRIGERATION 501.1,000M BTU X 139 -
10 BOILER/REFRIGERATION 1001-L75014 BTU X ., S57 •
11 BOILER/REFRIGERATION •1750M BTU X $95 -
-12 GAS LOG,GAS INSERT,GAS FIREPLACE - 2- X S10 - ail. an
13 RANGE - X $10 -
14 DRYER - X S10 -
15 FUEL BURNING WATER HEATER -• X S10 -
16 MISG FUEL BURNING APPL. •- X $10 -
17 GAS PIPING(aa.Outlet) - a X 51 - a. ofl
18 DUCT SYSTEMS - • X 110 -
19 VENTILATING FANS - / X S10 - /0.
2A AIR HANDLER(DOES NOT Indude ducting) -OR<10,000CFM X S12 -
21 AIR HANDLER(DOES NOT indudc ducting) - >10 000 CFM X $19 -
22 BVAPORATIVE COOLERS - X 510 -
-
23 TYPE 11400D - ^ X $50 -
24 TYPE/SNOOD - _ X 110 -
25 HEAT PUMP/ASR CONDITIONER 0-3 TON ` X $12 - /a. QO
2E AIR CONDMONER 3-15 TON X $20 -
_27 AIR CONDEnONER 15.30 TON X 123 •
28 AIR CONDITIONER 30.50 TON X $35 -
29 AIR CONDITIONER +50 TON X S60 -
30 LPG STORAGE TANK - X S10 -
31 WOOD OR PELLET STOVE/INSERT - X S10 -
32 WOOD STOVE•FREE STANDING - X $`
SUBTOTAL: t e�
00
+=HOD OF PAYMENT PLUS PROCESSING FEE: $35.00
y,,t TOTAL PERMIT FEE DUE: t t T
cAST- !CHBCX ❑ JIMMIE ❑ _ _ - .
)ATE: EXPIRES:
LANKCARD NUMBED
1UTHORIZED SIGNATURE: