2005, 04-01 Permit App: 05001055 Mechanical Fixtures 04/0112005 4:25 5094841405 RR HEATING PAGE 01/01
MECHANICAL PERMIT APPLICATION Community Development Department
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Phone: (509)688-0036; FAX: (509)888-0037 Building Division
11707 E. Sprague Avenue, Suite 106
For Inspections, Call (509) 688-0054 Spokane Valley, WA 99206
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Project Address;19004 E.4th Ave., Permit Use:
Owner: Fred Otto Phone(Daytime Contact) :466-5021
Mailing Address 19004 E.4th Ave. Spokane Valley WA 99016
City Contractor: R&R Heating and A/C, Inc. License*: RRHEAA'1069W Phone#: (509)4841405 State Zip Code
Mailing Address:4019 E.Central Ave. Spokane WA 99217
City State Zip code
DESCRIPTION OF WORK #OF UNITS X COST = TOTAL AMOUNT_
1 FUEL BURNING APPLIANCE Ettual to or leas than 100,000 1 X $12,00 >; I a,e)0
2 FUEL BURNING APPLIANCE - More than 100,000 X $15.00 =
3 UNLISTED APPLIANCE Additional Fee, E•ual to or less than 400 000 X $50.00 = _
_ 4_ UNLISTED APPLIANCE(Additional Fee) More than 400,000 X - $100,00 =
5 USED APPLIANCE(WSEC min.AFUE rating) Equal to or loss than 400,000 X $50.00 =
6 USED APPLIANCE(WSEC min.AFUE rating) More than 400.000X $100.00 =
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7 L. BOILER/REFRIGERATION 1-100M BTU X 4 $12.00 =
8 BOILER/REFRIGERATION 101-500M BTU X $20.00 =
9 BOILER/REFRIGERATION 501-1,000M BTU X $25.00 =
10 BOILER/REFRIGERATION 1 00 -1 750M BTU X '35.00 =
11 BOILER/REFRIGERATION 'More then 1,750M BTU X 4 $60.00 =
12 GAS LOG,GAS INSERT,GAS FIREPLACE ' X $10.00 = 10 .00
13 RANGE . X $10.00 a
14 DRYER
X $10.00 =
15 FUEL BURNING WATER HEATER I . X $10.00 = 10 10 6
16 MISC.FUEL BURNING APPLIANCE X $10.00 =
_17 _ GAS PIPING(each outlet) X $1.00 =
18 DUCT SYSTEMS X $10.00 =
19 VENTILATING FANS X $10.00 =
.20 AIR HANDLER(DOES NOT include ducting) Equal to or less than 10,000 CFM X $12.00 -
21 AIR HANDLER!`ODES NOT include ducting) Greater than 10,000 CFM n . $16.00 =
22 EVAPORATIVE COOLERS X $10.00 =
23 TYPE I HOOD - X $50.00 =
24 TYPE II H000 X $10,00 =
25 HEAT PUMP/AIR CONDITIONER 0-3 TON I X $12.00 = (. ..oO
26 AIR CONDITIONER 3.15 TON X $20,00 =
27 AIR CONDITIONER 16-30 TON X $25:00
28 AIR CONDITIONER 30-50 TONX $35.00
29 AIR CONDITIONER More than 50 TON X $60.00
.30 LPG STORAGE TANK X $10.00 =
31 WOOD OR PELLET STOVE/INSERT - X $10.00 =
32 .WOOD STOVE-FREE STANDING X $25.00 =
33 REPAIR&ADDITIONS X $15.00
34 VENTILATION SYSTEMS - _ X $12.00 =
35 VENTILATION MECHANICAL EXHAUST X $12.00 A _
36 INCINERATOR-RESIDENCE X $19.00 =
37. INCINERATOR-COMMERCIALX $22.00 =
METHOD OF PAYMENT: SUBTOTAL ' 1-114,O0
0 CASH 0 CHECK%)-VISA 0 MC DATE:
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PROCESSING FEE $35.00
CARO#: 0 7 p 1 /Q EXPIRES: Ql/U� TOTAL PERMIT FEE DUE: "Iu1 r0O ,
AUTHORIZED SIGNATURE:
APR 01 2005 14:32 5094841405 PAGE.01