2003, 05-21 Permit: BD03-477 Furnace SOTY I ,/ 11707 East Sprague Avenue,Suite 106 509-688-0036-Phone
• me Spokane Valley,WA 99206 509-688-0037-Fax
Val leY. For Inspections, call 509-688-0054
4000*
-Mechanical Permit Application
PROJECT PERMTT
ADDRESS: (flt B f)0e USE: &J2— d_s- 7
OWNER f r-k (Nr eh e r)k-e.. PHONE(Daytime Contact): 5e r7- ria(fT
MAILING ADDRESS:
137 '8 Zs, 31g Ave. ,,,��``1CL. mal(P
(street) (city/state) (ZIP)
CONTRACTOR: LICENSE#:
MAILING ADDRESS: PHONE#:
(street) (city/state) (ZIP)
DESCRIPTION OF WORK $OF UNITS X COST EQUALS AMOUNT
1 FUEL BURNING APPLIANCE -OR<100,000 t X $15 - j5,c1)
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 -
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 indude 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
IMMO" TOTAL PERMIT FEE DUE: O.C3
5
0 CASH 0 CHECK 0 0 ..___ '=� ' f
t
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
- 3 7
cf, 4 e
ifI/ ,4/7, To S7-se- c2 3 /tc.11
1