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2004, 07-14 Permit App: BLD-04-07062 ACTO'30ed SWStb8b60S City of Spokane Valley Mechanical Permit Application 82:FT b00? 90 inr Fax # 688-0037 Project Address: 3713 S Mc Donald Permit Use: Owner: Dave Holmes Phone (daytime contact): 924-7463 Mailing Address:SAME (street) citylstate) (zip) Contractor. R8R Heating and AC, Inc. License: RRHEAA106BW Mailing Address: 4019 E Central Phone#: 484-1405 Spokane, Wa 99217 (street) (city/state) (zip) DescfiptionofWork 0 o units Cost = 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 appliance (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 Boller/refrigeration 101-500M BTU X 26.00 = 0.00 9 Boiler/refrigeration 501-1.000M BTU X 39.00 = 0.00 10 Boiler/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- 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 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 19.00 = 0.00 22 Evaporative coolers - X 10.00 = 0.00 23 Type I hood- X 50.00 = 0.00 24 Type 11 hood - X 10.00 = 0.00 25 Heat pump/air conditioner 0-3 tons X 12.00 = 0.00 26 Air conditioner 3.15 tons 1 X 20 00 = 20.00 27 Alr 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 = 0.00 30 LPG storage tank - X 10.00 = 000 31 Wood or pellet stove/Insen- X 10.00 = 0.00 32 Wood stove - free standing - X 25.00 = 0.00 0 Cash 0 Check 0 Visa 0 MasterCard Faxed permits will only be accepted with payment of a major credit card � / /t blplb6 Date: / / T 1 ' r0 Expires: Subtotal 20 00 Plus Processing Fee 35.00 Total Permit Fee Due 55.00 Bankcard Number. Authorized Signature: TO/T0 39tid 9NIll73H tb SOSIVEVEO5 9T:ZT b00L/90/L0