2005, 04-27 Permit App 05001348 Wtr HtrSp 1 ems'`
.0 -a11ey
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206
Mechanical Permit Application
509-688-0037 - Fax
i'KVJECT y�J
ADDRESS: / D �/ 7 f `�-��%S%L .2/4-
PERMIT
USE:
OWNER:
PHONE (Daytime Contact): /2/ 7 r/' f
i' I
MAILING ADDRESS:
(street) (city/state) (ZIP)
CONTRACTOR: / ; ,/ p /�'� „ al,
LICET=#:1 .3Gs p g /
MAILING ADDRESS: r/
PHONE
,,C 770 (42.A.1)-6-1 7)f?-- e_-.Pil- .?)" 8 I `7(
_.,-.0
(street) (city/state) (ZIP)
METI-TOD OF PA
❑ CASH ❑ CI -
DESCRIPTION OF WORK
0 OF UNITS
X
COST
EQUALS
AMOUNT
1
FUEL BURNING APPLIANCE
- OR < 100,000
X
$15
-
2
FUEL BURNING APPLIANCE
> 100,000
X
519
3
UNLISTED APPLIAN E (ADDITIONAL FEE)
• OR <400,000
X
$50
-
4
UNLISTED APPLIANCE (ADDMONAL FEE)
> 400,000
X
5100
•
5
USED APPLIANCE (WSEC min. AFUE rating)
• or <400,000
X
550
-
6
USED APPLIANCE (WSEC min. AFUE rating)
> 400,000
X
5100
-
7
B
BOILER/REFRIGERATION
1 - 100M BTU
X
$15
-
8
BOILER/REFRIGERATION
10I - 500M BTU
X
$28
-
9
BOILER/REFRIGERATION
501- 1,000M BTU
X
539
•
10
BOILER/REFRIGERATION
1001 - 1,750M BTU
X
$57
-
11
BOILER/REFRIGERATION
+1750M BTU
X
$95
-
12
GAS LOG, GAS INSERT, GAS FIREPLACE
-
X
510
-
13
RANGE
-
X
$10
•
14
DRYER
-
X
$10
-
15
FUEL BURNING WATER HEATER
-
X
$10
-
/ ® SC
16
MISC FUEL BURNING APPL.
-
X
510
-
17
GAS PIPING (ea. Outlet)
-
X
51
-
18
DUCT SYSTEMS
-
X
510
-
19
VENTILATING FANS
-
X
510
•
20
AIR HANDLER (DOES NOT Include ducting)
- OR < 10,000CFM
X
512
-
21
AIR HANDLER (DOES NOT Include ducting)
> 10,000 CFM
X
519
-
22
EVAPORATIVE COOLERS
-
X
510
-
23
TYPE I HOOD
-
X
550
-
24
TYPE II HOOD -
-
X
510
•
25
HEAT PUMP/AIR CONDITIONER •
0-3 TON
X
512
•
26
AIR CONDMONER
3-15 TON
X
520
-
27
AIR CONDITIONER
15-30 TON
X
525
•
28
AIRCONDITIONER
30-50TON
X
535
-
29
AIR CONDITIONER
+50 TON
X
560
-
30 LPG
S
STORAGE TANK
--
X
510
-
31
WOOD OR PELLETSTOVE/INSERT
-
X
510
•
32
WOOD STOVE - FREE STANDING
-
X
525
•
r1ENT
^„
SUBTOTAL:
PLUS PROCESSING FEE:
$35.00
r , ' y ` : It , t
TOTAL PERMIT FEE DUE: /`1 �. - b(1
u
DATE:
EXPIRES:
BANKCARD NUMBER
AUTI-IORIZED SIGNATURE: