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2005, 06-17 Permit App: 05001894 AC 06/01/2005 11:51 5094841405 RR HEATING PAGE 03 615---/ e--( City of • Spokane Valley Mechanical Permit Application Fax#688-0037 Project 91Pi q Permit Address: -1016E.4th-ii4th-UC- Use; Owner: MT Management Phone(daytime contact): Mailing Address: SAME 922-3942 (street) Scity/stat+ (zip) Contractor: R&R Heating and AC, Inc. License: RRHEAA106BW • Mailing Address: 4019 E Central 'Phone#: 484-1405 Spokane,Wa 99217 (street) (city/state) (zip) Description of Work #of units Cost -• Amount 1 Fuel burning appliance -or<100,000 X ' 12,00 = 0.00 2 Fuel burntig appliance >100.000 X 15.00 = 0,00 3 Unlisted appliance(additional charge) -or<400.000 X 60.00 = 0.00 4 Unlisted appliance(additional charge) >400,000 X 100.00 = 0,00 5 Used appliance(WSEC's min.AFUE rating) =to or<400,00 X 50.00 a3 0.00 8 Used appliance(WSEC's min.AFUE rating) >400.000 X 100.00 = 1 0.00 7 Boiler/refrigeration 1-100M BTU X 12.00 = 0,00 8 Boiler/refrigeration 101-500M BTU X 20.00 0.00 9Boller/refrigeration 501-1,000M BTU X 26.00 = 0.00 10 Boiler/refrigeration 1,001-1,750M BTU X 35.00 = 0.00 11 Boiler/refrigeration +1,750M BTU X 60.007 -- 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 c 0.00 16 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 = 0.00 19 Ventilating fans - X 10.00 = 0.00 20 Alr handler(does not Include ducting) -or<10,000 CFM X 12.00 = 0.00 21 Air handler(does not Include ducting) >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 Heat pump/air conditioner 0-3 tons 1 X 12.00 = - 12.00 26 Air conditioner 3-15 tons X 20.00^ = 0.00 27 Air conditioner 15-30 tonsX 25.00 = 0.00 28 Air conditioner 30-50 tons X 35.00 = 0.00 29 Air conditioner +50 tons X 60.00 = 0.00 30 LPG storage tank - X 10.00 = 0.00 31 Wood or pellet stove/insert - 4 X 10.00 = 0.00 32 Wood stove-free standing - X 25.00 = 0.00 0 Cash 0 Check 71.,Visa ❑ MasterCard Subtotal 12.00 Faxed permits will only be accepted with payment of a major credit card Plus Processing Fee 35.00 Date: (0--re-() c Expires: 06/06 _ Total Permit Fee Due 47.00 Bankcard Number: On Fli Authorized Signature: l iM 0-0f-il 711> • • JUN 01 2005 13:02 5094841405 PAGE.03