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2004, 03-18 Permit App: BLD-04-03815 Heat Pump, AC03/16/2004 11:44 5094841505 City of Spokane Valley RR HEATING Mecfiianical Penult Application Fax # 688-00 PAGE 01/01 SI Project Address: 1112 S Newer Ct Permit Use: Owner: Jen Smith Phone (daytime contact): 869-5868 Mailing Address SAME (street) (city/state) (zip) Contractor: R&R Heating and AC, Inc. License: RRHEAA106BW Mailing Address 4019 E Central Phone#: 484-1405 Spokane, Wa 99217 (street) (dty/state) (zip) Description of Work # of units Cost is 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 m 0.00 6 Used appliance (WSEC's min. AFUE rating) > 400,000 X 100.00 = 0.00 7 Boller/refrigeration 1-100M BTU X 15.00 = 0.00 8 Boller/refrigeration 101500M BTU X 28.00 0.00 9 Boiler/refrigeration 501-1.000M BTU X 39.00 = 0.00 10 Bailer/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 16 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 II hood- X 10.00 = 0.00 25 Heat pump/air conditioner 0-3 tons 1 X 12.00 = 12.00 26 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 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 stand' g- X 25.00 = 0.00 ❑ Cash 0 Check t Visa 0 MasterCard Subtotal 12.00 Fared permits will only be accepted with payment or a major aedit card Plus Processing Fee 35.00 Date: Expires: Total Permit Fee Due 47.00 Bankcard Number: Authorized Signature: MAR 16 2004 10:50 5094841505 PAGE.01