2005, 07-22 Permit App: 05002495 AC 06/28/2005 13:24 5094841405 RR HEATING PAGE 01
Mechanical Permit Application Community Development Department
Building Division
City ofA 11707 E. Sprague Ave., Suite 106
Spokane Phone: (509) 688-0036; FAX: (509)688-0037 .
/ � Spokane Valley,WA 99206
Valley for Inspections,call (509)888-0054 �S - 2`A I J
c.. �,�-' Permit Use:
Project Address: 1920 N. Salmon River Lane �l.
Owner:
Mike Poulin -Phone(daytime contact): 922-2203
Valley,WA 99016
Mailing Address: 1920 N. Salmon River Lane Spokanecity state zit)code
Contractor: R&R Heating
License#: RRHEAA108BW Phone#: 484-1405
Mailing Address: 4019 E. Central Ave., Spokane, WA 99217 Gtr state zlo code
Description of Work • it of units x Cost = Amount
equal to or less than 100,000 X 12.00 = 0.00
1 Fuel burning applianceX 15.00 = 0.00
2 Fuel buminjappliance more then 100,000
equal to or less than 400,000 X 50.00 = 0.00
3 Unlisted appliance(additional charge) � X 100 00 0.00
4 Unlisted appliance(additional charge) more than 400,000 X 50.00 = 0.00
5 Used appliance(WSEC's min.AFUE rating) equal to or less than 400,000
more then 400,000 X 100.00 = , 0.00,
8 Used appliance(WSEC's min.AFUE rating) 0.00
7 Boiler/refrigeration 1-100M BTU X 12.00 =
8 Boiler/refrigeration _ 101-500M BTu X 20.00 = 0.00
9 Boiler/refrigeration
501-1,000M BTU X 25,00 = 0.00
,.
10 Boilerlrefrlgeration 1,001-1,750M BTU X 35.00 = 0.00
11 Boller/refrigeration 1,750M 1750M BTU X 60.00 = 0.00
0.00
12 Gas log,gas insert,gas fireplace X 10.00 =
X 10.00 = 0.00 X 10.00 =
13 Range 0.00
14 Dryer 0.00
=
15 Fuel burning water heater . X 10.00
fiance X 10.00 = 0.00
16 Miscellaneous fuel burning app 0,00
17 Gas piping,(each outlet) X 1.00 =
X 10.00 = 0.00
18 Duct systems , X 10.00 = 0.00
19 Ventilating fans 0.00
20 Air handler(does not include ducting) equal to or less than 10,0000 CFM X 12.00 =
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 = 0.0012.00
25 Heat pump/air conditioner 0-3 ton 1 X 12.00 =
26 Air conditioner
3-15 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
X 60.00 = 0.00
29 Air conditioner more than 50 ton ,
X 10.00 = 0.00
30 LPG storage tank X 10.00 0.00
31 Wood or pellet stov&ineert 5.00 = 0.00
32 Wood stove-free standing X X 2 215.00 = 0.00
33 Repair&additions X 15.00 =- 0.00
34 Ventilation systems X 12.00 0.00
35 Ventilation mechanical exhaust X 18.00 = 0.00
36 Incinerator-residence X 22.00 = 0.00
37 incinerator-commercial
Method of payment: 0 Cash 0 Check 0 Visa 0 MasterCard Subtotal 12.00
Card#: ON FILE Processing Fee 35.00
Date: 8/28/2005 Expires: Jun-06 Total Permit Fee Due: 47.00
Authorized Signature:
JUN 28 2005 14:36 5094841405 PAGE.01