2004, 08-26 Permit App: BLD-04-07480 Heat Pump, ACI0 ' 30thd
SOSIb8t6OS
City of
Spokane Valley
Mechanical Permit Application
LI:60 VOW sz Jflti
Fax # 888-0037
Project
Address: 2017 N Hodges
Permit
Use:
Owner. J R Montgomery
Mailing Address SAME
Phone (daytime contact):
893-8775
(street)
Contractor: R&R Heating and AC, Inc.
Mailing Address 4019 E Central
Spokane, Wa 99217
Scity/state)
License: RRHEAMO6BW
(np)
Phone#: 484-1405
(street)
(city/state)
(zip)
1
2
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7
8
9
Description of Work
Fuel burning appliance
Fuel buming appliance
# of units
Cost
Amount
- or < 100,000
X
15.00
0.00
Unlisted appliance (additional charge)
Unlisted appliance (additional charge)
> 100,000
x
19.00
0.00
- or < 400,000
X
50.00
Used appliance (WSEC's min. AFUE rating)
Used appliance (WSEC's min. AFUE rating)
Boiler/refrigeration
Boiler/refrigeration
Boiler/refrigeration
> 400,000
X
100.00
-or<100,000
X
580.00
> 400,000
x
100.00
1-100M BTU
X
15.00
101-500M BTU
X
28.00
10
Boller/refrigeration
501-1,000M BTU
X
39.00
11
Boller/refrigeration
1,001-1,750M BTU
X
57.00
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Gas log, gas insert, gas fireplace
Range
Dryer
+ 1.750M BTU
•
X
95.00
X
10.00
a
a
X
10.00
Fuel buming water heater
X
10.00
Miscellaneous fuel burning appliance
Gas piping, (each outlet)
Duct systems
X
10.00
X
10,00
X
1.00
Ventilating fans
x
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
X
19.00
X
10.00
X
Type II hood
X
50.00
Heat pump/air conditioner
Air conditioner
Air conditioner
Air conditioner
Air conditioner
0-3 tons
1
X
X
10,00
12.00
3-15 tons
X
20.00
15-30 tone
X
25.00
30-50 tone
X
36.00
LPG storage tank
+ 50 tons
Wood or pellet stovenneert
Wood stove - free standing
❑ Cash 0 Check 0 Visa 0 MasterCard
Faxed permits will only be accepted with payment or a major credit card
Date: Expires:
Bankcard Number.
Authorized Signature:
TO/T0 39Cd
X
X
X
X
60.00
10.00
10.00
25.00
a
9NIlti3H ?1
Subtotal
0.00
0.00
0,00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
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
S2STbBb60S T0:60 b00Z/SZ/80