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2004, 08-24 Permit App: BLD-04-07478 AC50;' TO"30dd SOSTv8v6OS City of Spokane Valley Mechanical Permit Application zv:TT v00z sz Dnd Fax # 688-0037 Project Address: 3506 N Center Rd Permft Use: Cwvner. Betty Carroll Phone (daytime contact): 924-3717 Mailing Address SAME (street) (c' /state) (zip) Contractor. R&R Heating and AC, Inc. License: RRHEAA1068W Mailing Address 4019 E Central Spokane, We 99217 (street) Phone#: ci /state(zip) 484-1405 Descri tion of Work 8 of units cost = Amount 1 Fuel bumin a iance - or < 100,000 X 15.00 = 0.00 2 Fuel burning appliance > 100,000 X 19.00 a 0.00 3 Unlisted appliance additional charge) - or < 400,000 X 50.00 s 0.00 4 Unlisted appliance (additional charge) > 400,000 X 100.00 0.00 5 Usad appliance SEC's min. AFUH ra ) 8 I Used appliance EC's min. AFUE rating) - or < 100.000 > 400,000 X X 580.00 100.00 = 0.00 0.00 7 Boiler/refri eretlon 1-100M BTU X 15.00 = 0.00 8 Boiler/refrl oration 101500M BTU X 28.00 = 0.00 91 Boller/refrigeration 501-10001V! BTU X 39.00 = 0.00 10 Boller/refr' oration 1,001.1,760M BTU X 57.00 = 0.00 11 Bolledrefrl oration + 1.750M BTU X 95.00 = 0.00 12 Gas log. gas insert as fireplace X 10.00 = 0.00 13 RanGe X 10.00 = 0.00 14 D er - X 10.00 s 0.00 15 Fuel bumin Water heater - X 10.00 0.00 16 Miscellaneous fuel burning appliance - X 10.00 = 0.00 17 Gas piping (each outlet) X 1.00 = 0.00 18 Duct systems 19 VentilatiN fans - - X X 10.00 10.00 = = 0.00 0.00 20 Air handler does not include ducting) - or < 10,000 CFM X 12.00 = 0.00 21 Air handler does not include ducting) > 10',000 CFM X 19.00 0 0.00 22 Eva orative coolers - X 10.00 = 0.00 23 Type I hood - X 50.00 = 0.00 24 Type ll hood - X 10.00 = 0.00 25 Heat pump/air conditioner 0-3 tons 1 X , 12.00 = 12.00 26 Air conditioner 3-15 tons X- 20.00 = 0.00 27 Air conditioner 28 1 Air conditioner 15-30 tons 30-50 tone X X 25.00 35.00 - = 0.00 0.00 29 Alr conditioner +'50 tons X 60.00 = 0.00 30 LPG storage tank - X 10.00 = 0.00 31 Wood or pellet stoverinsert 32 Wood stove - free standing - - X X 10.00 25.00 = = 0.00 0.00 D Cash C3 Check ❑ Visa ❑ Mastercara Faxed permits vAll only be accepted with payment of a major credit carts Rate: Expires, Bankcard Number. Authorized Signature: TO/TO 39Vd 9NI1173H dd OuUtUL01 12.001 Plus Processing Fee 35•00 Total Permit Fee Due 47.00 S09TG9v609 9Z:TT t?00Z/SZ/B0