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2003, 12-15 Permit App: BLD-03-03272 Mechanical Fixtures12/12/2bt9J 1b: J.1 7n'74a41On0 City of Spokane Valley Mechanical Permit Application Fax # 688-0037 Project Address: 1421 N Oberlin - or < 400,000 Permit Use: %001 = Owner. Jim Greene 4 Unlisted appliance additional charge) Phone (daytime contact): 926-7981 Mailing Address SAME street (city/state zl Contractor. RSR Heating and AC, Inc. - or < 100,000 License: RRHEAA106BW Mailing Address 4019 E Central Spokane, Wa 99217 street Phone#: (city/state) 484-1405 (zJ Descr/ tion of Work # of units Coat I Amount 7 Boiler/refrigeration 1 Fuel1urning appliance - or < 100,000 1 1 1 X 15-0011 15.00 0.00 2 Fuel burning appliance > 100,000 1 1 X 19.0011 0.00 28.00 = unymea appiiance aaamonai charge) - or < 400,000 I X %001 = 0.00 4 Unlisted appliance additional charge) > 400,000 X 100.00 = 0.00 5 Used applianoe (WSEC's min. AFUE rating) - or < 100,000 X 580.00 - 0.00 6 Used appliance SEC's min. AFUE rating) > 400,000 X 100.00 = 0.00 7 Boiler/refrigeration 1-100M BTU X 15.00 = 0.00 8 Boiler/refrl erabon 101 -SWM BTU X 28.00 = 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/refri tion + 1,750M BTU X 95.00 0.00 12 Gas log, gas insert, gas fireplace - X 10,00 13 Range - X 10.00 = 0,00 14 Dryer - X 10.00 fl 0.00 15 Fuel burning water heater - X 10.00 a 0.00 16 Miscellaneous fuel burning appliance - X 10.00 0.00 17 Gas piping, (each outlet) X 1.00 = 1.00 18 Ducts stems 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 m 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 Heatpump/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 26 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) - X 25.00 - 0.00 ❑ Cash ❑ Check ❑ Visa ❑ MasterCard Faxed permits wN only be accepted with payment of a major credit card Date: Expires: Bankcard Number. Authorized Signature: Subtotal Plus Processing Fee Total Permit Fee Due 28.00 35.00 63.00 DEC 09 2003 15:46 5094841505 PAGE.01