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2004, 09-17 Permit App: BLD-04-07681 Mechanical FixtureT0'30idd SOGIVEO60S City of kane Valle Mechanical Permit Application SS:GO 7002 GT d3S Fax # 688-0037 Project Address: 14023 E Desmet Permit Use: Owner: Robert Havens Phone (daytime contact): 534-7914 Mailing Address SAME (street) fcitylstete) (Hp) Contractor: R&R Heating and AC, Inc. License: RRHEAA106BW Mailing Address 4019 E Central Phone#: 484-1405 Spokane, Wa 99217 (street) (cltylstate) (zip) Description of Work # of units Cost = Amount 1 Fuel burning appliance - or < 100,000 1 X 15.00 = • 15.00 2 Fuel burning appliance > 100,000 X 19.00 = 0.00 3 Unlisted appliance (additional charge) - or <400,000 X 50.00 = 0.00 4 Unlisted appliance (additional charge) > 400,000 X 100.00 = 0.00 5 Used appliance (WSEC's min. AFUE rating) • or < 100,000 X 580.00 = 0.00 6 Used appllance (WSEC's min. AFUE rating) > 400,000 X 100.00 = 0.00 7 Boller/refrigeration 1-100M BTU X 15.00 = 0.00 8 Bolledrefrigeration 101-500M BTU X 28.00 = 0.00 9 Boiler/refrigeration 501-1,000M BTU X 39.00 = 0.00 10 Boller/refrigeration - 1,001-1,750M BTU X 57.00 = 0.00 11 Boller/refrigeration + 1,750M BTU X 95.00 = 0.00 12 Gas log, gas Insert, gas fireplace - X 10.00 = 0.00 13 Range - X 10.00 = 0.00 14 Dryer - X 10.00 = 0.00 15 Fuel burning water heater - X 10.00 = 0.00 16 Miscellaneous fuel burning appliance • X 10.00 in 0.00 17 Gas piping, (each outlet) • X 1.00 s 0.00 18 Duct systems - X 10.00 = 0.00 19 Ventilating fans • X 10.00 = 0.00 20 Arr handler (does not include ducting) - or < 10000 CFM X 12.00 = 0.00 21 Alr handler (does not Include ducting) > 10.000 CFM X 19.00 = 0.00 22 Evaporative coolers - X 10.00 = 0.00 23 Type I hood - X 50.00 = 0.00 24 Type 11 hood - X 10.00 = 0.00 25 Heat pump/alr conditioner 0-3 tons X 12.00 = 0.00 26 Air conditioner 3.15 tone X 20.00 = 0.00 27 Air conditioner 15-30 tons X 25.00 = 0.00 28 Air conditioner 30-50 tons X 35.00 = 0.00 20 Alr conditioner + 50 tons X 60.00 = 0.00 30 LPG storage tank - X 10.00 = 0.00 31 Wood or peuet stove/Insert - X 10.00 = 0,00 32 Wood stove - free standing - X 25.00 -� = 0.00 0 Cash CI Check 0 Visa 0 MasterCard Faxed permits vI0 only be accepted with payment or a major mart card Date: Expires: Subtotal 15.00 PIUS Processing Fee 35.00 Total Permit Fee Due 50.00 Bankcard Number. Authorized Signature: TO/T0 391dd D 1C4( 9NIlti3H ya S2ST78p60S BE:LO 700E/LT/60