2004, 08-05 Permit App: BLD-04-07243 Furnace T O'30tid SOS t 1781760S LZ:OZ t'00Z b0 J(lts
,' w
q74 -5
City of
Spokane Valley Mechanical Permit Application Fax#688-0037
Project Permit
Address: 12423 E 24th Use:
Owner. Sue Wiley Phone(daytime contact):
999-2646
Mailing Address SAME
(street) (city/state) (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 I of units Cost = Amount
1 Fuel burning appliance -or<100,000 , 1 X 15.00 = 15.00
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 = 0-00
6 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 Boller/refrigeration 101500M 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 Boiier/refrigeratkm +1,750M BTU . X 95.00 = 0.00
12 Gas log,gas insert,was 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
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 Ventilatingfans - 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 19.00 = 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 X 12.00 = 0.00
28 Air conditioner 3-15 tons X 20.00 = ' 0.00
27 Air conditioner 1530 tons X 25.00 am 0.00
28 Air conditioner 30-50 tons X 35.00 = 0.00
29 Air conditioner +50 tons X 80.00 = 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
.�. oaf!
❑ Cash 0 Check ❑ Visa 0 MasterCard Subtotal
15.00
Faxed permits will only be accepted with payment Of a major credit card Plus Processing
Fee 35.00
Date: Expires: Total Permit Fee
Due 50.00
Bankcard Number.
Authorized Signature:
•
t0/tO 39Cd ONI.L 3H elel SOStiBb60S Et:OT 0002/b0/B0