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2004, 08-06 Permit App: BLD-04-07287 Furnace, AC TO'3Jtid SOSTPBb60S ES:17T b00Z SO 9fld ri A tr) City of Spokane Valley Mechanical Permit Application Fax#688-0037 Project Permit Address: 11601 E 25th Use: Owner. Gary Faire Phone(daytime contact): 926-7313 Mailing Address SAME (street) (city/state) (ziP) Contractor: R&R Heating and AC,Inc. License: RRHEAA106121W Mailing Address 4019 E Central Phone#: 484-1405 Spokane.Wa 99217 (street) (city/state) (zip) Description of Work #of units Cost as 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 6 Used appliance(WSEC's min.AFUE rating) -or<100,000 X 580.00 = 0.00 8 Used appliance(WSEC's min.AFUE rating) >400,000 X 100.00 s 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 Boiler/refrigeration +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 16 Miscellaneous fuel burning appliance - X 10,00 = 0.00 17 Gas piping,(each outlet) - x 1,00 = o.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 handier(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 Typo II hood - X 10.00 = 0.00 25 Heat pump/air conditioner 0-3 tons 1 X 12.00 = 12.00 26 Alr conditioner 3-15 tons , X 20.00 = 0.00 27 Air conditioner 15-90 tons X 25.00 = 0.00 28 Air conditioner 30-50 tons X 35.00 ' 0.00 29 Air conditioner +50 tons X 80.00 a 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 a 0.00 ❑ Cash 0 Check CI Visa ❑ MasterCard Subtotal 27.00 Faxed permits win only be accepted with payment of a major credit card Plus Processing Fee 35.00 Date: Expires: Total Permit Fee Due 62.00 Bankcard Number: Authorized Signature: TO/TO 39t7d 9NI1173H Zld SOSttU81760S 6E:17T 1700Z/S2/80