2005, 03-21 Permit App: 05000790 Heat Pump, AC03/15/2005 12:54 5094841405
City of
Spokane Phone: (509) 688-0036; FAX (509) 688-0037
/ Valley for inspections, call (509) 688-0054
Project Address: 1907 S. St Charles Rd.
Owner:
KK nGH I lIMla
Mechanical Permit Application
Mailing Address:
Contractor.
Mailing Address:
Josephine Kiliingsworth
1907 S. St Charles Rd.
R & R Heating
License #:
4019 E. Central Ave., Spokane, WA 99217
RRHEAA106BW
0%5 790
Community Development Department
Building Division
11707 E. Sprague Ave., Suite 106
Spokane Valley, WA 99206
Permit Use:
Phone (daytime contact): 927-1893
Spokane Valley, WA
tate Otte
Phone#:
otv
state
99037
fi3 code
484-1405
zio code
Authorized Signature:
MAR 15 2005 13:00
5094841405
PAGE.01
Description of Work
# of units
x
Cost
=
Amount
1
Fuel burning appliance
equal to or less than 100,000
X
12.00
0.00
2
Fuel burning appliance
more than 100,000
X
15.00
=
0.00
3
Unlisted appliance (additional charge)
equal to or less than 400,000
X
X
50.00
100.00
=
=
0.00
0.00
4
Unlisted : • • lance additional ch: ! e
more than 400,000
5
Used appliance (WSEC's min. AFUE rating)
equal to or lase than 400,000
more than 400,000
X
X
50.00
100.00
=
®
0.00
0.00
6
Used appliance (WSEC's min. AFUE rating)
7
Boller/refrigeration
1-100M BTU
-
X _
12.00
¢
0.00
8
Boiler/refrigeration
101-600M BTU
X
20.00
=
0.00
9
Bolter/refrigeration
501-1,000M 8TU
X
25.00
=
0.00
10
Boiler/refrigeration
1,001-1,750M BTU
X
35.00
=
0.00
11
Boiler/refrigeration
+ 1,750M BTU
X
80.00
=
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
18
Duct systems
X
10.00
m
0.00
19
Ventilating fans
X
10.00
=
0.00
20
Alr handler (does not Include ducting)
equal to or less 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
T • e 1 hood
X
50.00
=
0.00
24
Type II hood
X
10.00
ae
0,00
25
Heat pump/air conditioner
03 ton
1
X
12.00
=
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
a:
0.00
29
Air conditioner
more than 50 ton
X
60.00
=
0.00
30
LPG story . e tank
X
10.00
m
0.00
31
Wood or pellet stove/insert
X
10.00
=
0.00
32
Wood stove - free standing
X
25.00
=
0.00
33
Re !air 8 additions
X
15.00
0.00
34
Ventilation systems
X
12.00
=
0.00
35
Ventilation mechanical exhaust
X
X
12.00
18.00
=
=
0.00
0.00
38
Incinerator - residence
37
Incinerator - commercial
X
22.00
=
0.00
Method of payment: 0 Cash 0 Chock o Vsaa 0 MasterCard
Card #: 6)-1 \
Subtotal
12.00
Processing Fee
3 5
Date: %s c(} Expires: "O‘/O �/rq O
Total Permit Fee Due:
4'va___
A - r4
Authorized Signature:
MAR 15 2005 13:00
5094841405
PAGE.01