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2005, 07-01 Permit App: 05002149 AC 06/20/2005 15:56 5094841405 RR HEATING PAGE 01/01 City of CS e-- 2./LfC Spokane Valley Mechanical Permit Application Fax#688-0037 Project Address: 17805 E. 4th Ave. Permit Use: Owner: Joel Horn Phone(daytime contact): 534-9322 Mailing Address: 1828 S. Wardson Spokane Valley WA 99212 (street) City State (zip) Contractor: R&R Heating and AC, Inc. License#: RRHEAA`108BW Phone#: 484-1405 Mailing Address: 4019 E Central Spokane WA 99217 (street) Zip Code Description of Work #of units Cost m Tota/Amount 1 Fuel burning appliance -or<100,000 X 12,00 = 0.00 2 Fuel burning appliance > 100,000 X 15.00 = 0.00 3 Unlisted appliance(additional charge) _ -or<400,000 X 50.00 = 0.00 (Unlisted appliance(additional charge) >400,000X 100,00 = 0.00 5 Used appliance(WSEC's min.AFUE rating) =to or<400,00 _ X 50.00 = 0.00 6 Used appliance(WSEC's min.AFUE rating) >400,000 X 100.00 = 0.00 7 Boiler/refrigeration 1-100M BTU _ X 12.00 = 0.00 8 Boiler/refrigeration 101-500M BTU X 20,00 = 0.00 9 Boiler/refrigeration 501-1,000M BTU X 25.00 - 0.00 10 Boiler/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 Dryer - X 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 - X 10.00 = 0.00 19 Ventilating fans - X 10,00 = 0.00 20 Air 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 = 0.001 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 tons X 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 - X _ 10.00 = 0.00 32 Wood stove-free standing - X 25.00 = 0.00 33 REPAIRS&B ADDITIONS X 15,00 = 0.00 34 VENTILATION SYSTEMS X 12.00 = 0.00 35 VENTILATION MECHANICAL EXHAUST X 12.00 = 0.00 36 INCINERATOR-RESIDENCE X 19.00 = 0.00 37 INCENERATOR-COMMERCIAL X 22.00 = 0.00 0 Cash 0 Check J .Visa 0 MasterCard SUBTOTAL 12.00 Faxed permits will only be accepted with payment of a major credit card PROCESSEING FEE 35.00 Date: Expires: 06106 TOTAL PERMIT FEE DUE: 47.00 Bankcard Number: On File Authorized Signature: JUN 20 2005 17 07 5094841405 PAGE.01