2004, 01-27 Permit App: BLD-04-03471 Mechanical Fixtures' OF
Sp(ITIokane
,,,,Walley
11707 East.Spragu2 Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206 509-688-0037 - Fax
For Inspections, call 509-688-0054
Mechanical Permit Application
PROJECT
ADDRESS: jE
V�
PERMIT
USE:
COST EQUALS AMOUNT
OWNER
Y
PHONE (Daytime Contact):
MAILING ADDRESS:
2 FUEL BURNING APPLIANCE
> 100,000
X
(street)
(city/state)
- OR < 400,000
(ZIP)
CONTRACTOR:%,
l/�l� ��
LICENSE #:
oo � 6A -)l a cP
MAILING ADDRESS:
s .�-y
PHONE #:
S (j+6 u e Spy kAjvc v ry
ctV /6
(street)
(city/state)
6 USED APPLIANCE (WSEC min. AFUE rating)
(ZIP)
METHOD OF PAY
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 BOILERIREFRIGERATION
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 -
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 11 HOOD
-
X
$10 -
25 HEAT PUMP/ATR 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 STOVEANSERT
-
X
$10 -
32 WOOD STOVE - FREE STANDING
-
X
1 $25 -
MENT
SUBTOTAL:
PLUS PROCESSING FEE: $35.00
TOTAL PERMIT FEE DUE:
❑ CASH ❑ CHECK ❑ ❑ l =
DATE:
BANKCARD NUi IBEIL-
AUTHORIZED SIGNATURE:
EXPIRES: