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2004, 08-03 Permit App: BLD-04-07209 Heat Pump, ACti0'301dd SOSTt'81760S City of Spokane Valley Mechanical Permit Application SS :60 b00Z VT inr i7ai Fax # 888-0037 Project Address: 2001 N Grady Ln Permit Use: Owner. Mason Hiatt Phone (daytime contact): 922-6318 Mailing Address: SAME (street) (ay/state) fzlp) Contractor. R&R Heating and AC, Inc. License: RRHEAA108BW Mailing Address: 4019 E Central Spokane, Wa 99217 Phone* 484-1405 - (street) (city/state) (zip) Description of Work # of units Cost s Amount 1 Fuel burning appliance - or < 100,000 X 15.00 = 0.00 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 apptance (WSEC's min. AFUE rating) - or < 100,000 X 580.00 = 0.00 6 Used appliance (WSEC's min. AFUE rating) > 400.000 X 100.00 = 0.00 7 Boiler/refrigeration 1-100M BTU X 15.00 = 0.00 8 Boiler/refrIgeration 101-500M BTU X 28:00 = 0.00 - 9 Boiler/refrigeration 501-1,000M BTU X 39.00 = 0.00 10Boiler/refrigeration 1,001-1,750M BTU X 57.00 = 0.00 11 Boiler/refrigeration * 1,750M BTU X 95.00 = 0.00 12 Gas log, gas insert, gas fireplace - X 10.00 = 0.00 13 Range _ 14 15 16 17 18 19 20 21 22 23 24 25 28 27 28 29 30 31 Dryer Fuel buming water heater Miscellaneous fuel buming agpllance Gas piping. (each outlet) Duct systems X X 10.00 10.00 10.00 x 10.00 Ventilating fans X X 1.00 10.00 Air handler (does not include ducting) Air handler (does not include ducting) Evaporative coolers Type 1 hood X 10.00 - or < 10,000 CFM X 12.00 > 10,000 CFM Type 11 hood Heat pump/air conditioner Air conditioner Air conditioner Air conditioner Air conditioner X X X X 19.00 10.00 $0.00 10.00 0-3 tons 1 X 12.00 3-15 tan X 15-30 tons 30-50 tons X X 20.00 25.00 35.00 LPG storage tank * 50 tons Wood or pellet stove/insert X X 80.00 10.00 32 Wood stove - free standing Cash ❑ Check 0 Visa 0 MasterCard Rued permits wtll only be accepted with payment of a meior credit card Date: Expires: Bankcard Number: Authorized Signature: TO/TO 39Vd 9NI1C3H NN X 10.00 25.00 Subtotal 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 12.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 12.00 Plus Processing Fee 35.00 Total Permit Fee Due 47.00 50Stb8b60S Zb:60 b00Z/17t/L0