2005, 08-10 Permit App: 05002836 ACblitun zutin 14: 172 7tr74a414uo
MM 2,--TX3149
Mechanical Permit Application f 4 - Community Development Department
City of / Building Division
Spokane Phone: (509) 688-0036; FAX: (509) 688-0037 11707 E. Sprague Ave., Suite 106
/ Valley for Inspections, call (509) 688-0054 Spokane Valley, WA 99206
Project Address: 3709 S. Loretta Drive - --.3_5/. 3 212_ Permit Use:
Owner: Doug Burk
Mailing Address: 3709 S. Loretta Drive
Phone (daytime contact): (509) 926-0463
Spokane Valley WA
city state
Contractor: R & R Heating & A/C, Inc. License #: RRHEAA"106BW Phone#:
Mailing Address: 4019 E. Central Ave.
Spokane
city
WA
state
99206
zip code
484-1405
99217
zip coati
Authorized Signature: 11�Li1
AUG 05 2005 15:15
5094841405 PAGE.01
Description of Work
# units
x
Cost
=
Amount
1
Fuel burning appliance
equal to or less than 100,000
X
12.00,
=
0.00
2
Fuel burning appliance
more than 100,000
X
15.00
=
0.00
3
Unlisted appliance (additional charge)
equal to or less than 400,000
X
50.00
=
0.00
4
Unlisted appliance (additional charge)
mere than 400,000
X
100.00
=
0.00
5
Used appliance (WSEC's min. AFUE rating)
equal to or less than 400,000
X
50.00
=
. 0.00
6
Used appliance (WSEC's min. AFUE rating)
more than 400,000
X
100.00
=
0.00
7
Boiler/refrigeration
1-100M BTU
X
12.00
=
0.00
8
Boiler/refrigeration
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
0.00
11
Boiler/refrigeration
+ 1,750M BTU
X
80.00
=
_ 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 burning_appliance
X
10.00
=
0.00
17
Gas piping, (each outlet)
X
1.00
=
0.00
18
Duct systems
-
X
10.00
=
0.00
19
Ventilating, fans
X
X
10,00
12.00
=
=
0.00,
0.00
20
Air handler (does not include ducting)
equal to or less than 10,0000 CFM
21
Alr handler (does not include ducting)
Greater than 10,000 CFM
X
15.00_
=
0.00
22
Evaporative coolers
X
10.00
=
0.00
23
Type t hood
X
50.00
=
0.00
24,
Type II hood
X
10.00
=
0.00
25
Heat pump/air conditioner
0-3 ton
1
X
12.00
=
12,00
26
Air conditioner
3-15 ton
X
20.00
=
0.00
27
Air conditioner
15-30 ton
X
25.00
=
0.00
28
Air conditioner
30-50 ton
X
35.00
=
0.00
29
Air conditioner
more than 50 ton
X
60.00
=
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
Repair & additions
X
15.00
=
0.00
34
Ventilation s stems
X
12.00
=
0.00
35
Ventilation mechanical exhaust
X
12.00
=
0.00
36
Incinerator - residence
X
18.00
=
0.00
37
Incinerator - commercial
X
22.00
=
0.00
Method of payment: 0 Cash 0 Check 0
Card #: ON FILE
Visa 0 MasterCard
Subtotal
12.00
Processing Fee
35.00
Date: 8/3/2005 n Expires:
Jun -08/i
Total Permit Fee Due:
f
47.00
,I
Authorized Signature: 11�Li1
AUG 05 2005 15:15
5094841405 PAGE.01