2005, 12-05 Permit App: 05004507 Mechanical Fixtures11/29/2005 11:46 5094948332 RRHEATING PAGE 01
Permit Center
� 11707 E. Sprague Ave., Suite 106
►�� OKa ne Spokane Valle}; SVA 99206
(509)688-003AX
6 F:(509)688-0037
"� �e�l +� z _s wi <,nw«lleti l3. c o,1t PERMIT NUMBER:
Community Development PEF��IIT FEE:
Mechanical Permit Application ❑ Commercial aResidential
SITE ADDRESS 13518 E. 4th Spkane Valley,lVA 99216
Building owner:
Name: Dave Weiler
Pho:ie: 928-6842
Fax:
Address: 13518 E. 4th
Contractor: R & R Heating & A/C, Inc.
City: Spokane Valley
State: WA
Zip:
99212
Name:
Pho 1e: 484-1405
Fax: 484-8332
Address: 4.019 E. Centrai Ave.
License No: RRHEAA`106BW
City: Spokane State: WA
City Business License No:
Zip:
99217
DESCRIPTION OF WORK
# OF UNITS X
CCST =
TOTAL AMOUNT
1 FUEL BURNING APLIANCE
Equal to or le ss than 100,000
1 X
12.00 =
12.00
2 FUEL BURNING APLIANCE
More than 100,000
X
15.00 =
0.00
3 UNLISTED APPLIANCE (Additional Fee)
Equal to or Ie ss than 400,000
X
50.00 =
0.00
4 UNLISTED APPLIANCE (Additional Fee)
More th 3n 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
6 USED APPLIANCE (WSEC's min. AFUE rating)
More th-in 400,000
X
100.00 =
0.00
7 SOILER'REFRIGERATION
1-10(IM BTU
I X
12.00 =
0,00
8 BOILER/REFRIGERATION
101-5oOM BTU
X
20.00 =
0.00
9 BOILERIREFRIGERATION
501-1,000M BTU
X
25.00 =
0.00
10 BOILER/REFRIGERATION
1,001-1,7501;, BTU
X
35.00 =
0.00
11 BOILERiREFRIGERATION
More than 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 BURING WATER HEATER
X
10.00 =
0.00
16 MIS. FUELBURNING APPLIANCE
_
X
10.00 =
0.00
17 GAS PIPING (each unit)
X
1.00 =
0.00
18 DUCT SYSTEM
X
10.00 =
0.00
19 VENTILATING FANS
I X
10.00 -
0.00
20 AIR HANDLER (DOES NOT include ducting)
Equal to or less han 10,0000 CFM
X
12.OU =
0.00
21 AIR HANDLER (DOES NOT include ducting)
Greater thea 1-10,000 CFM
X 1
15.00 =
0.00
22 EVAPORATIVE COOLERS
X
10.001 = I
0.00
23 TYPE 1 HOOD
X
50.00 =
0.00
24 TYFE II HOOD
X,
10.00 1
0.00
25 HEATPUMP/AIR CONDITIONER
0-3 TON
1 X
12.001
12.00
26 AIR CONDITIONER,
3-1: TON
X
20.00 =
0.00
27 AIR CONDITIONER
15-3) TON
X
25.00 =
0.00
28 AIR CONDITIONER
30 -Sr) TON+XX
35.00 =
0.00
29 AIR CONDITIONER
More then 5C TON
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 IREPAIR & ADDITIONS
X
15.00 =
0.00
34 IVENTILATION SYSTEMS
_
X
12.00 =
0.00
35 VENTILATION MECHANICAL EXHAUST
X
12.00 =
0.00
36 INCINERATOR - RESIDENCE
_
X
19.00 =
0.00
37 INCINERATOR - COMMERCIAL
X
22.00 =
0.00
METHOD OF PAYMENT:
❑ CASH ❑ CHECK 17 VISA ❑ MC
CARD #: ON FILE r1
)) cc
DATE:
EXPIRES: 06/06
,
SUBTOTAL
PROCESSING FEE
TOTAL PERMIT FEE DUE:
24.00
35.00
58.00
Authorized Signature: ?I''v
I
NOV 28 2005 12:04 5094B48332 PAGE.01