2005, 07-22 Permit App: 05002497 Mechanical Fixtures 07/01/2005 15:18 5094841405 RR HEATING PAGE 01/01
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Mechanical Permit Application c,5; (27 Community Development Department
City of A Building Division
Spokane Phone: (509)688-0036; FAX: (509)688-0037 11707 E. Sprague Ave., Suite 106
Valley for Inspections, call(509)888-0054 11 C 7. d 1 Spokane Valley,WA 99206
Project Address: 17518 E. 3RD LANE Permit Use:
Owner: SHEA LINDSEY Phone(daytime contact): (509) 998-4271
Mailing Address: SAME AS ABOVE Spokane Valley WA 99016
city state zip code
Contractor: R&R Heating &A/C, Inc. License#: RRHEAA*106BW Phone#: 484-1405
Mailing Address: 4019 E. Central Ave. Spokane WA 99217
city state zm code
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 50.00 = 0.00
4 Unlisted appliance(additional charge) more than 400,000 X 100.00 = 0.00
5 Used appliance(WSEC's min.AFUE rating) equal to or less than 400,000 X 50.00 - 0.00 j
8 Used appliance(WSEC's min.AFUE rating) more than 400,000 X 100.00 = 0.00
7 Boiler/refrigeration 1-100M BTU X 12.00 = 0.00
8 Boiler/refrigeration 101-5OOM BTU X 20.00 = 0.00
9 Boiler/refrigeration 501-1,000M BTU X 25.00 = 0.00
10 Boller/refrigeration 1.001-1,750M BTU X 35.00 = 0.00
11 Boiler/refrigeration +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 DryerX 10.00 = 0.00
15 Fuel burning water heater X 10.00 = 0.00
18 Miscellaneous fuel burning appliance , X 10.00 = 0.00
17 Gas piping, (each outlet) X 1.00 = 0.00
18 Duct systems 1 X 10.00 = 10.00
19 Ventilating fans X 10.00 = 0.00
20 Air 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 coolersX 10.00 = 0.00
23 Type I hood X _ 50.00 = 0.00
24 Type II hood _ X 10.00 = 0.00
25 beat pump/air conditioner 0-3 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 j
28 Air conditioner 30-50 ton X 35.00 = 0.00
29 Air conditioner more than 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
38 Incinerator-residence X 18.00 = 0.00
37 Incinerator-commercial _ X 22.00 = 0.00
Method of payment: ❑ Cash 0 Check 0 Visa 0 MasterCard Subtotal
22.00
Card#: ON FILE Processing Fee 35.00
Date: 6/28/2005 Expires: Jun-06 Total Permit Fee Due: 57.00
Authorized Signature:
JUL 01 2005 16 29 5094841405 PAGE.01