2005, 07-22 Permit App: 05002491 AC 07/20/2005 15:48 5094841405 RR HEATING PAGE 01
1
�I:
�3\ Community Development Department i
Mechanical Permit Application L. -
Building Division
City ofA � � Suite 106
Spokane v 11707 E. Sprague Ave.,
Phone: (509) 888-0036; FAX: (509)688-0037 L1� ��
Valley for Inspections, call (509)688-0054
Spokane Valley,WA 99208 1
Project Address: 1912 N. Salmon River Lane
Permit Use: '' I
Phone(daytime contact): (509) 475-4876
Owner: Josh Miller
Spokane Valley WA 99018 '1
Mailing Address: 1912 N. Salmon River Lane P city state zip code
#: 484-1405 `'I
Contractor: R&R Heating &A/C, Inc. License#: RRHEAA*106BW Phone
•
Spokane WA 99217
Mailing Address: 4019 E. Central Ave. state zio code I'
citv i
11
Description of Work #units x Cost =
Amount
X 12.00 0.00
1 Fuel burning appliance equal to or lees than 100.000 = 0.00
more than 100,000 X 15.00
2 Fuel burning appliance 1
equal to or less than 400,000 X 50.00 = 0.00
3 Unlisted appliance(additional charge) X 10000 = 0.00
4 Unlisted appliance(additional charge) more than 400,000 . 0 00 ,
5 Used appliance(WSEC's min.AFUE rating) equal to or less than 400,000 X 100.00X 50.00 = 0.006 Used appliance(WSEC's min.AFUE rating) more than 400,000
7 Boiler/refrigeration = 0.00
1-100M BTU X 12.00
X 2000 = 0.00
8 Boller/refrigeration 101.500M B .
TU = 0.00
501-1,000M BTU X 25.00
9 Boiler/refrigeration X 35.00 = 0.00 l
10 Boiler/refrigeration 1,001-1,150M BTU
11 Boiler/refrigeration 0.00
+1,750M BTU X 60.00 = ; I
X 10.00 r- 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 i' ;
15 Fuel, burning water heater 0.00 f
i
16 Miscellaneous fuel burning appliance X 10.00 _1.00 = 0.00
17 Gas piping, (each outlet) X - 0.00
18 Duct systems X 10.00X 10.00 = 0.00 '
19 Ventilating fans X 12.00 = 0.00 i
20 Air handler(does not include ducting) equal to or less then 10,0000 CFM X 15.00 = 0.00
21 Air handler(does not Include ducting) Greater then 10,000 CFM X 10.00 = 0.00 I
22 Evaporative coolers X 50.00 = , 0.00
23 Type 1 hood X 10.00 = 0.00
24 Type Il hood 1 X 12.00 = 12.00
25 Heat pump/air conditioner 0-3 ton
26 Air conditioner
3-15 ton X 20.00 a �0.00
27 Air conditioner 15-30 ton X 25.00 = 0.00
26 Air conditioner = 0.00
30-50 ton X 35.00
f X 0.0029 Air conditioner more then 50 ton 60.00 = 0.00
,
X 10.
30 LPG storage tank X 10.00 00 = 0.00
31 Wood or pellet stove/Insert X 10 = 0.00 j
32 Wood stove-free standing X 25.005.00 = 0.00
33 Repair&additions X 12.00 = 0.00
34 Ventilation systems - X 12.00 = 0.00
35 Ventilation mechanical exhaust X 12.00 = 0.00
36 Incinerator-residence X 22.00 = 0.00 ;,
37 Incinerator-commercial Subtotal
Method of payment: C Cash ❑ Check 0 Visa O MasterCard 12.00
Card#: ON FILE
Processing Fee 35.00
'
Date: Expires: Jun-06 Total Permit Fee Due: 47.00
Authorized Signature:
JUL 20 2005 17 01 5094841405 PAGE.01