2003, 10-09 Permit App: BLD-03-02727 Heater, Piping ..- y
r-sion orj� 11707 East Sprague Avenue,Suite 106 509-688-0036-Phone
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ne Spokane Valley,WA 99206 509-688-0037-Fax
40,0v Valley
Mechanical Permit Application
PROJECT PEIL
ADDRESS:ii1 - re, v - `°G/ /( USES:I /7/P/-12-1-,-/
OWNER: c--^ PHONE(Daytime Contact):
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MAILING ADDRESS:
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(street) (city/state) (ZIP)
CONTRACTOR: / LICENSE#:
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PHONE#:
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(street) (city/state) (ZIP)
DESCRIPTION OF WORK 9 OF UNITS X COST EQUALS AMOUNT
1 FUEL BURNING APPLIANCE =OR<100,000 X ' $15 =
2 FUEL BURNING APPLIANCE ,. >100,000 X $19 = A7
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 , S50 =
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 =
16 MISC FUEL BURNING APPL - X - $10 _
17 GAS PIPING(ea.Outlet) - X $1 - f'
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: a 6.J
METHOD OF PAYMENT PLUS PROCESSING FEE: $35.00
r
VIS ;V.-u p TOTAL PERMIT FEE DUE: ( _
❑ CASH ❑ CHECK ❑ El ! .....:2'..1.
•
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: