2004, 08-05 Permit App: BLD-04-07244 AC 10'30tid SOS Tb8b60S VS:ST b00i✓ 8Z lflf
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City of
Spokane Valley Mechanical Permit Application Fax#0388-0037
Project Permit
Address: 10123 E 18th Use:
Owner: Jay Holder Phone(daytime contact):
928-0738
Mailing Address SAME
(street) (city/state) (zip)
Contractor: R&R Heating and AC,Inc. License: RRHEAA106BW
Mailing Address 4019 E Central Phone#: 484-1406
Spokane,Wa 99217
(street) (city/state) (zip)
Description of Work #of units Cost Amount
1 Fuel burning appliance -or<100,000_ X 15.00 a 0.00
2 Fuel burning appliance >100.000 X 19.00 = 0.00
3 Unlisted appliance(additional charge) -or<400.000 X 50.00 = 0.00
4 Unlisted appliance(additional charge) >400.000 X 100.00 = 0.00
5 Used appliance(WSEC's min.AFUE rating) -or<100,000 X 580.00 a 0.00
8 Used appliance(WSEC's min.AFUE rating) >400,000 X 100.00 = 0.00
7 Boiler/refrigeration 1-100M BTU X 15.00 = 0.00
8 Boiler/refrigeration 101.500M BTU X 28.00 = 0.00
9 Boiler/refrigeration 501-1,000M BTU X 39.00 = 0.00
10 Boiler/refrigeration 1,001-1,750M BTU X 57.00 = 0,00
11 Boilerfrefrigeration +1,750M BTU X 95.00 = 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 - t 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 handier(does not Include ducting) >10.000 CFM X 19.00 = 0.00
22 Evaporative coolers - X 10.00 = 0.00
23 T pe 1 hood - X 50.00 M 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
28 Air conditioner 3-15 tons X 20.00 = 0.00
27 Air conditioner 15-30 tons X 25.00 = 0.00
28 Air oonditloner 30-50 tons X 36.00 = 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
0 Cash 0 Check 0 Visa 0 MasterCard Subtotal
12.00
Fax*"permits will only be accepted with payment of a major creek card Plus Processing
Fee 35.00
Date: Expires: Total Permit Fee
Due 47.00
Bankcard Number:
Authorized Signature:
TO/TO 391dd SNI1ti3H dd S0Stb8b60S 00:gi b00Z/8Z/L0