2005, 11-09 Permit App: 05004231 AC11/07/2UUb 15: db 517y4b4U.J52
Spokane
Mill
Permit Center
11707 E. Sprague Ave., Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
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Community Development
Mechanical Permit Application
SITE ADDRESS
KKfl -l1 liVl7
0 C. ommerci al 54 -Residential
PERMIT NUMBER: ` -
PERMIT FEE: L`--
3213 S. Roble Roe Spokane, WA '9206
Building owner:
Name: Ricardo Cortez Phc ne: 710-8463 Fax:
Address: 3213 S. Roble Road City: Spokane Valley State: WA Zip: 99212
Contractor: R & R Heating & A/C, Inc.
Name: Phc ne: 484-1405 Fax: 484-8332
Address: 4019 E. Central Ave. City: Spokane
State: WA Zip: 99217
No:
License No: RRHEAA*1068W City Business License
DESCRIPTION OF WORK
it OF UNITS
X
COST
=
TOTAL AMOUNT
1
FUEL BURNING APLIANCE
Equal to or Liss than 100,000
X
12.00
=
0.00
2
FUEL BURNING APLIANCE
More tl an 100,000
X
15.00
=
0.00
3
UNLISTED APPLIANCE (Additional Fee)
Equal to or I ass than 400,000
X
50.00
=
0.00
4
UNLISTED APPLIANCE (Additional Fee)
More tl an 400,000
X
100.00
=
0.00
5
USED APPLIANCE (WSEC's min. AFUE rating)
Equal to or I':ss than 400,000
X
50.00
=
0.00
6
USED APPLIANCE (WSEC's min. AFUE rating)
More ti an 400,000
X
100,00
=
0.00
7
BOILER/REFRIGERATION
1-1(OM BTU
X
12.00
=
0.00
8
BOILER/REFRIGERATION
101-t OM BTU
X
20.00
=
0.00
9
BOILER/REFRIGERATION
501-1,000M BTU
X
25.00
=
0.00
10
BOILER/REFRIGERATION
1,001-1,750M BTU
X
35.00
=
0.00
11
BOILER/REFRIGERATION
More than 1,750M BTU
X
60.00
=
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 BURING WATER HEATER
X
10.00
=
0.00
16
MIS. FUELBURNING APPLIANCE
X
10.00
=
0.00
17
GAS PIPING (each unit)
X
1.00
=
0.00
18
DUCT SYSTEM
X
10.00
=
0.00
19
VENTILATING FANS
X
10.00
=
0.00
20
AIR HANDLER (DOES NOT include ducting)
Equal to or les: than 10,0000 CFM
X
12.00
=
0.00
21
AIR 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 I HOOD
X
50,00
=
0.00
24
TYPE II HOOD
X
10.00
=
0.00
25
HEATPUM/AIR CONDITIONER
0-3 TON
1
X
12.00
-
12.00
26
AIR CONDITIONER
3-' 5 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
AlR CONDITIONER
More ttIan 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 SYSTEMS
X
12.00
=
0.00
35
VENTILATION MECHANICAL EXHAUST
X
12.00
-
0.00
36
INCENERATOR - RESIDENCE
X
18.00
=
0.00
37
INCENERATOR - COMMERCIAL
X
22.00
=
0.00
METHOD OF PAYMENT:
El CASH 0 CHECK i VISA ❑ MC
CARD 4: ON FILE
Authorized Signature: CJ Vt
DATE:
EXPIRES(
) (�
/ /! J V! J 0.
SUBTOTAL
12.00
PROCESSING FEE
35.00
P
Pi
06/06
l�+
TOTAL PERMIT FEE DUE:
47.00
NOl1 07 2005 15:23
5894848332
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