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2004, 06-09 Permit App: BLD-04-04537 Heat Pump, AC
TO'391dd SOS Tt'8P60G 9t:0t P00ir E0 Nflf OA..._ 453 7 City of Spokane Valley Mechanical Permit Application Fax#688-0037 Project Permit Address: 11116E 37th Use: Owner. Dan Goodman Phone(daytime contact): 928-1906 Meiling Address:SAME (street) Jcitylstate) (zip) Contractor R&R Heating and AC, Inc. License: RRHEAA106BW Mailing Address: 4019 E Central Phone#: 484-1405 Spokane,Wa 99217 (street) (citylstate) (Zap) Description of Work Si of units Cost = Amount 1 Fuel burning appliance -or<100,000 X _ 15.00 = 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 C 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 101-500M BTU X 28,00 = 0,00 9 Boller/refrigeration , 501-1,000M BTU X 39.00 = 0.00 10 Boller/refrigeration 1,001-1,750M 8TU , X 57.00 = 0.00 11 Boller/refrigeration + 1,750M BTU X 95.00 a 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 = 0.00 18 Duct systems - X 10.00 is 0.00 19 Ventilating fans - X 10.00 2. 0.00 20 AIr handier(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 li hood - X 10.00 = 0.00 25 Heat pump/air conditioner 0-3 tons 1 X 12.00 2 12,00 26 Air conditioner 3-15 tons X 20.00 = 0.00 27 Air conditioner 15-30 tons X 25.00 = 0.00 28 Air conditioner 30-50 tons X 35.00 0.00 29 Air conditioner +50 tons , )r 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 i�= 0.00 ❑ Cash 0 Check 0 Visa O MasterCard Subtotal 12.00 Food permits will only oa accepted with payment of a major credit card Plus Processing Fee 35.00 Date: Expires: Total Permit Fee Due 47.00 Bankcard Number: Authorized Signature: TO/T0 3Etid ENI103H He' SOST17B1760S 90:0T 1700Z/E0/90