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2005, 07-22 Permit App: 05002494 AC 07/20/2005 15:48 5094841405 RR HEATING PAGE 02 ri Mechanical Permit Application ,- - /1 Community Development Department City of A • L1-)- L. ( Building Division Spokane Phone: (509)688-0036: FAX: (509)688-003 11707 E. Sprague Ave., Suite 106 Valley for Inspections, call (509)888-0054 ,) O Spokane Valley,WA 99206 i' Project Address: 10905 E.26th Ave. Permit Use: }' Owner: Randy Bases Phone(daytime contact): (509) 939-5082 Mailing Address: 10905 E. 26th Ave. Spokane Valley WA 99206 city state zip code Phone#: 484-1405 1 Contractor: R&R Heating &A/C, Inc. License#: RRHEAA`108BW { Mailing Address: 4019 E. Central Ave. Spoykhane WA 99217 zio code Description of Work #units x Cost = Amount - = 100000_ 1 Fuel burning appliance equal to or less than , X 12.00 2 Fuel burning appliance more than 100.000 X 15.00 0.00 - 0.00 3 Unlisted appliance(additional charge) equal to or less than 400,000 X 50.00 = 0.00 more than 400,000 X 100,00 = 0.00 4 Unlisted appliance(additional charge) = 0.00 5 Used appliance(WSEC's min.AFUE rating) equal to or less than 400.000 X 50.00 6 Used appliance(WSEC's min.AFUE rating) more than 400,000 X 100.00 = 0.00 7 Boiler/refrigeration 1-100M BTU X 12.00 0.00 1 8 Boiler/refrigeration 101-500M BTU , X 20.00 = 0.00 9 Boiler/refrigeration 501-1,000M BTU X 25.000.00 00 - 0.00 � 10 Boiler/refrigeration 1,001-1,750M BTU X 35. 11 Boller/refrigeration +1,750M BTU X 80.00 -= 0.00 12 Gas log,gas insert,gas fireplace X 10.00 = 0.00 13 Range X 10.00 = 0.00 0.00 14 Dryer X 10.00 = 15 Fuel burning water heater X 10.00 - 0.00 0,00= IE' 16 Miscellaneous fuel burning appliance X 10.00 = , 17 Gas piping, (each outlet) X 1.00 = 0.00 1', i 18 Duct systems X 10.00 = 0.00 I 19 Ventilating fans 20 Air handler(does not include ducting) equal to or lees than 10,0000 CFM X - 12.00 0.00 i 15.00II - 0.00 X 21 Air handler(does not include ducting) Greater than 10,000 CFM = 0.00 - 22 Evaporative coolers X 10.00 = 23 Type I hood X 50.00 - 0.00 24 Type II hoodX 10.00 25 Heat pump/air conditioner 0-3 ton 1 X 12.00 == 12.00 I 26 Air conditioner 3-15 ton X 20.000.00 1. 27 Air conditioner 15-30 ton X 25.00 = 0.00 28 Air conditioner 30-50 ton , X 35.00 = 0.00 29'Air conditioner more than 50 ton X 60.00 = 0.00 i' 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 Repair&additions X 15.00 = 0.00 34 Ventilation systems - = X 12.00 0.00 X 12.00 0.00 35 Ventilation mechanical exhaust = 36 Incinerator-residence - ~ 0.00 X 18.00 = 37 Incinerator-commercial X I 22.00 = 0.00 Method of payment: 0 Cash 0 Check 0 Visa 0 MasterCard Subtotal 12.00 1! Card#: ON FILE Processing Fee35.00 I, Date: Expires: Jun-06 Total Permit Fee Due: 47,00 Authorized Signature: 1 JUL 20 2005 17:02 5094841405 PAGE.02 1 oSocco70a CIP.