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2004, 02-05 Permit App BLD-04-03508 Air Test Gas PipingSi t kane ,1_ Valley 11707 East Sprague 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: ) L f( 0- — 0 Vkis, kik ," 1 A PERMIT USE: OWNER: GuichcntCs CcxQ��tl ( -`r PHONE (Daytime Contact): 7 co_ , l o s---+ MAILING ADDRESS: Zszq $ K60Ytd luJ A-1u) oKtAk LEA q t7G3 (street) (city/state) (ZIP) CONTRACTOR: LICENSE #: MAILING ADDRESS: PHONE #: (street) (city/state) (ZIP) METHOD OF PA ❑ CASH DATE: DESCRIPTION OF WORK 8 OF UMTS 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 < 900,000 X $50 - 4 UNLISTED APPLIANCE (ADDITIONAL FEE) > 900,000 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/REFRIGERAT1ON 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 595 - 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) - I 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 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 525 - VIENT VISA' SUBTOTAL: PLUS PROCESSING FEE: $35.00 _,c a TOTAL PERMIT FEE DUE: CHECK ❑ ❑ '. �"_ EXPIRES: BANKCARD NUMBER: AUTHORIZED SIGNATURE: