2004, 10-30 Permit App: BLD-04-08105 InsertT0' 30tid
50;118460S
City of
�4�nP VAIIPV �/1 �.1A Mechanical Permit Application
50:4T P00? 6E 130
Fax # 688-0037
(street
Description of Work
1 Fuel burning appliance I
2 Fuel burning appliance
3 Unlisted appliance (additional charge)
4 Unlisted appliance (additional charge)
5 Used appliance (WSEC's min. AFUE rating)
6 Used appliance (WSEC's min. AFUE rating)
7 Boller/refdgeratlon
8 Boiler/refrigeration
9 Boiler/refrigeration
10 Boiler/refrigeration
11 Boiler/refrigeration
12 Gas log, gas Insert, gas fireplace
13 Range
14 Dryer
15 Fuel burning water heater)
16 Miscellaneous fuel burning appliance
17 Gas piping. (each outlet)
18 Dud systems
19 Ventilating fans
20 Alr handler does not include ductint
21 Air handler docs not Include ductm,
•orative coolers I
e I hood
22 Eva
23 T
24 Type II hood
25 Heat pum•/air conditioner
26 Air conditioner
27 Air conditioner
28 Air conditioner
29 Alr conditioner
30 LPG store; a tank
31 Wood or
32 Wood stove - free stand'n
0 Cash 0 Check 0 Vise 0 MasterCard
Faxed permits will only be accepted with payment of a moor credit card
Expires:
•
ellet stove/Insert
•
- or <100,000
> 100,000
- or < 400,000
> 400,000
- or < 100,000
> 400,000
1-100M BTU
101500M BTU
501-1.000M BTU
1,001-1,750M BTU
+ 1,750M BTU
if of units Cost
X 15.00 =
X 19.00 =
X 50.00 =
X 10000 -
x 580.00 =
X 100.00 =
X 15.00 =
X 28.00
X 39.00 =
x 57.00 =
X 95.00 =
1 X 10.00 =
X 10.00 =
x 10.00 =
X 10.00 =
X 10.00
X 1.00
x ' 10.00
X r 10.00
X I 12.00
X 19.00
X 10.00
X 50,00
X 10.00
X 12.00
X 20.00
Amount
-or< 10.000CFM
>10.000 CFM
0-3 tons
3-15 tons
15-30 tons
30-50 tons
+ 50 tons
Date:
Bankcard Number.
Authorized Signature.
TO/T0 39t1d
9NIlV3H Cie!
X
X 35.00 =
X 80.00 =
10.00
X 10.00 =
X 25.00 -
Subtotal
Plus Processing
Fee
Total Permit Fee
Due
SOSTb6b605
0,00
0.00
0.00
0.00
0.00
0.00
0.00
0 00
0.00
0.00
0.00
10.00
0.00
0,00
0.00
0.00
0,00
000
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
10.00
35.00
45.00
o1US.
9b:ET b00Z/63/0T
Project
Address: 12322 E Maty
;.....---
Ct
Permit
Use:
Owner: Bob Clapper
Phone (daytime contact):
891-7107
Melling Address SAME
(street)
(city/state)
(zip)
Contractor: R&R Heating and AC, Inc.
License:
RRHEAA106BW
Mailing Address 4019 E Central
Spokane. Wa 99217le.ltol
Phone#:
4841405
want
(zip)
(street
Description of Work
1 Fuel burning appliance I
2 Fuel burning appliance
3 Unlisted appliance (additional charge)
4 Unlisted appliance (additional charge)
5 Used appliance (WSEC's min. AFUE rating)
6 Used appliance (WSEC's min. AFUE rating)
7 Boller/refdgeratlon
8 Boiler/refrigeration
9 Boiler/refrigeration
10 Boiler/refrigeration
11 Boiler/refrigeration
12 Gas log, gas Insert, gas fireplace
13 Range
14 Dryer
15 Fuel burning water heater)
16 Miscellaneous fuel burning appliance
17 Gas piping. (each outlet)
18 Dud systems
19 Ventilating fans
20 Alr handler does not include ductint
21 Air handler docs not Include ductm,
•orative coolers I
e I hood
22 Eva
23 T
24 Type II hood
25 Heat pum•/air conditioner
26 Air conditioner
27 Air conditioner
28 Air conditioner
29 Alr conditioner
30 LPG store; a tank
31 Wood or
32 Wood stove - free stand'n
0 Cash 0 Check 0 Vise 0 MasterCard
Faxed permits will only be accepted with payment of a moor credit card
Expires:
•
ellet stove/Insert
•
- or <100,000
> 100,000
- or < 400,000
> 400,000
- or < 100,000
> 400,000
1-100M BTU
101500M BTU
501-1.000M BTU
1,001-1,750M BTU
+ 1,750M BTU
if of units Cost
X 15.00 =
X 19.00 =
X 50.00 =
X 10000 -
x 580.00 =
X 100.00 =
X 15.00 =
X 28.00
X 39.00 =
x 57.00 =
X 95.00 =
1 X 10.00 =
X 10.00 =
x 10.00 =
X 10.00 =
X 10.00
X 1.00
x ' 10.00
X r 10.00
X I 12.00
X 19.00
X 10.00
X 50,00
X 10.00
X 12.00
X 20.00
Amount
-or< 10.000CFM
>10.000 CFM
0-3 tons
3-15 tons
15-30 tons
30-50 tons
+ 50 tons
Date:
Bankcard Number.
Authorized Signature.
TO/T0 39t1d
9NIlV3H Cie!
X
X 35.00 =
X 80.00 =
10.00
X 10.00 =
X 25.00 -
Subtotal
Plus Processing
Fee
Total Permit Fee
Due
SOSTb6b605
0,00
0.00
0.00
0.00
0.00
0.00
0.00
0 00
0.00
0.00
0.00
10.00
0.00
0,00
0.00
0.00
0,00
000
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
10.00
35.00
45.00
o1US.
9b:ET b00Z/63/0T