2003, 11-20 Permit App: BLD-03-03118 Vent Fan aTy(T-.4110.111111111%041, 11707 East Sprague'Aveircie,Suite 106 509-688-0036-Phone
ne Spokane Valley,WA 99206 509-688-0037-Fax
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Mechanical Permit Application c3 TJ11é
PROJECT
PERMIT
ADDRESS: USE:
OWNER: PHONE(Daytime Contact):
MAILING ADDRESS: '
(street) (city/state) (ZIP)
CONTRACTOR: . LICENSE#:
MAILING ADDRESS: • PHONE#:
(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 I-100M BTU X $15 -
8 BOILER/REFRIGERATION 101-500M ETU 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 - I X $10 -
20 AIR HANDLER(DOES NOT include ducting) =OR<10,000CFM X $12 =
21 MR 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
r•._,.._.._f `:R.1
t f%- TOTAL PERMIT FEE DUE:
•El CASH ❑ CHECK El Min E1L_____.:.:_...1
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DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: