2005, 11-04 Permit App: 05004227 AC01/01/2002 20:11 5094835255 AES
Permit Center
11707 E. Sprague Ave., Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
tvwwspoknneval lev.o recon i
Spokane
4.000Mtliey
Community Development
Mechanical Permit Application
❑ (2cmmercial 0 Residential
PAGE 01
PERMIT NUMBER: 4271+
PERMIT FEE: 4.7
SITE ADDRESS
8203 E. Frederick . Spokane, WA Sc. 212
Building owner:
Name: Jim Potts Phore: 924-3629 Fax:
Address: 8203 E. Frederick Ave CI y: Spokane Valley State: WA Zip. 99212
Contractor: R & R Heating & A/C, Inc.
Name: ',Phore' 484-1405 Fax: 484-8332
Address: 4019 E. Central Ave. Ci.y: Spokane State: WA Zip: 99217
License No' RRHEAA'106BW City Business License
No:
ti OF UNITS
X
COST
=
TOTAL AMOUNT
DESCRIPTION OF WORK
1
FUEL BURNING APLIANCE
Equal to or less than 100,000
X
12.00
=
0.00
2
FUEL BURNING APLIANCE
More th; n 100,000
X
15_00
=
0.00
3
UNLISTED APPLIANCE (Additional Fee)
Equal to or lens than 400,000
X
50.00
=
0.00
4
UNLISTED APPLIANCE (Additional Fee)
More tn: n 400,000
X
100 00
=
0,00
5
USED APPLIANCE (WSEC's min AFUE rating)-
Equal to or le -s than 400,000
X
50.00
=
0.00
6
USED APPLIANCE (WSEC's min AFUE rating)
More thi n 400,000
X
100 00
=
0.00
7
BOILER/REFRIGERATION
1 -10th BTU
X
1200
=
000
8
BOILER/REFRIGERATION
101-5(OM BTU
X
20.00
=
0,00
9
BOILER/REFRIGERATION
501-1,030M BTU
X
2500
=
0.00
10
BOILER/REFRIGERATION
1,001-1, '507.1 BTU
X
35.00
=
0.00
11
BOILER/REFRIGERATION
More than 1,750M STU
X
60.00
=
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 BUSING WATER HEATER -
X
10.00
=
0.00
16
MIS. FUELBURNING APPLIANCE
X
10.00
=
0.00
17
GAS PIPING (eacn unit)
X
1.00
=
0.00
18
DUCT SYSTEM
X
10,00
=
000
19
VENTILATING FANS
X
10.00
=
0.00
20
AIR HANDLER (DOES NOT include ducting)
Equal to or less han 10,0000 CFM
X
12.00
=
0 00
21
AIR HANDLER (DOES NOT include ducting)
Greater tha'i 10,000 CFM
X
15.00
=
0.00
22
EVAPORATIVE COOLERS
X
1000
=
0.00
23
TYPE I HOOD
X
50-00
0.00
24
TYPE II HOOD
X
10.00
=
0.00
25
HEATPUM/AIR CONDITIONER
0-` TON
1
X
12.00
=
12.00
26
AIR CONDITIONER
3-1fi TON
X
20.00
=
0.00
27
AIR CONDITIONER
15-20 TON
X
2500
=
0.00
28
AIR CONDITIONER
30-E3 TOtJ
X
3500
=
000
29
AIR CONDITIONER
More thrin 50 TON
X
6000
=
0.00
30
LPG STORAGE TANK
X
10.00
=
0.00
31
WOOD OR PELLET STOVE/INSERT
X
10 00
=
0.00
32
WOOD STOVE - FREE STANDING
X
25.00
=
0.00
33
REPAIIR & ADDITIONS
X
15.00
=
0,00
34
VENTILATION SYSTEMS
X
12.00
' =
0.00
35
VENTILATION MECHANICAL EXHAUST
X
12,00
=
000
36
INCENERATOR - RESIDENCE
X
18.00
=
0.00
37
INCENERATOR - COMMERCIAL
X
2200
=
0,00
METHOD OF PAYMENT_(�
o CASH 0 CHECK 0 VISA 0 MC
CARD #: ON FILE
,/
DATE: l r U
SUBTOTAL
12.00
PROCESSING FEE
3.5 00
EXPIRES: 06/06
TOTAL PERMIT FEE DUE:
47.00
Authorized Signature.
NOV 0-: 2005 39:00
5094935255 PRGE.01