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2005, 04-13 Permit App: 05001139 AC04/08/2005 Elf:1( City of Spokane Valley Project Address: Owner: Mailing Address: Contractor: Mailing Address: 5by4ti414U 1923 N. Hodges Lane Patrick Melby 1923 N. Hodges Lane (street) R&R Heating and AC, Inc. 4019 E Central (street) MM MCP -11111 Mechanical Permit Application 05- 1139 Fax # 688-0037 Permit Use: Phone (daytime contact): 893-8909 Spokane Valley WA city License#: RRHEAA'106BW Spokane 99016 State (zip) Phone#: 484-1405 WA 99217 Authorized Signature: APR 08 2005 08:23 5094841405 PAGE.01 Description of Work *of units Cost @ i-iy vuuo Total Amount 1 Fuel burning applianoe - or < 100,000 X 12.00 = 0.00 2 Fuel burning appliance > 100,000 X 15.00 = 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) = to or <400,00 X 50.00 = 0.00 6 Used appliance (WSEC's min. AFUE rating) > 400,000 X 100.00 = 0.00 7 Boiler/refri • eration 1-100M BTU X 12.00 = 0.00 8 Boiler/refri • eratlon 101-500M BTU X 20.00 = 0.00 9 Boller/refrigeration 501-1,000M BTU X 25.00 = 0.00 10 Boiler/refrigeration 1,001-1,750M BTU X 35.00 = 0.00 11 Boiler/refrigeration + 1,750M BTU 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 burning water heater - X 10.00 = 0.00 16 Miscellaneous fuel bumin• a• •liance - X 10.00 = 0.00 17 Gas piping, (each outlet) - X1.00 = 0.00 18 Duct systems - X 10.00 = 0.00 19 Ventilatln• fens X 10.00 = 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 15.00 = 0.00 22 Eva•orative coolers - X 10.00 = 0.00 23 Type I hood - X 50.00 = 0.00 24 Type II hood - X 10.00 = 0.00 25 Heat um /air conditioner 0-3 tons 1 X 12.00 = 12.00 28 Air conditioner 3-15 tons 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 29 Air conditioner + 50 tons X 60.00 30 LPG store tank - X = 10.00 = 0.00 31 Wood or 0.00 pellet stove/insert - X 10.00 32 Wood = 0.00 stove - free standing - X 25.00 = 0.00 33 REPAIRS &B ADDITIONS X 15,00 = 0.00 34 VENTILATION SYSTEMS X 12.00 = 0.00 35 VENTILATION MECHANICAL EXHAUST X 12.00 = 0.00 36 INCINERATOR - RESIDENCE X 19.00 = 0.00 37 INCENERATOR - COMMERCIAL X 22.00 = 0.00 0 Cash 0 Check • Visa ❑ MasterCard Faxed SUBTOTAL 12.00 permits will only be accepted with payment of a major credit card Date: PROCESSEING FEE 35.00 Expires: 06/06 TOTAL PERMIT FEE DUE: 47.00 Ranlrr r 1 Ail rr•k .- n_ ca_ Authorized Signature: APR 08 2005 08:23 5094841405 PAGE.01