2004, 06-26 Permit App: BLD-04-04738 AC TO'3OI d SOS Tt'8b60S SISI V00Z VZ NRC
n .7
)CK1
City of
Spokane Valley Mechanical Permit Application Fax#688-0037
Project Permit
Address: 13017 37th Ct Use:
Owner. Donald Roberts Phone(daytime contact):
927-8433
Mailing Address:SAME
(street) city/state) (zip)
Contractor. R&R Heating and AC,Inc. License: RRHEAA1066W
Mailing Address: 4019 5 Central Phones: 484-1405
Spokane,Wa 99217
(street) jcityy/state) (zip)
Description of Work • s 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 = 0.00
5 Used appliance(WSEC's min.AFUE rating) -or<100,000 X 580.00 = i 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 Ec 0.00
0.00
8 BolledrefrigeratIon 101-500M BTU X 2800
9 Boiler/refrigeration 501-1,000M =
8TU , X 39.00 ,, 0.00
10,Boiler/refrigeration 1,001-1,750M BTU X 57.00 0.00
11 Boller/refrigeration , +1.750M BTU X 95.00 = 0.00
12 Gas log,gas insert.gas fireplace - X 10.00 u 0.00
X 10.00 0.00
13 Range -- X 10.00 = 0.00
'14 Dryer
15 Fuel burning water heater - X 10.00 = 0.00
18 Miscellaneous fuel burning appliance - X 10.00 = 0.00
X 1.00 = 0.00
17 Gas piping,(each outlet) X 10.00, m 0.00
18 puct systems - X 10.00 s 0.00
19,Ventilating fans
20 Air handler(does not include ducting) -or<10.000 CFM X 12.00 TS 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
X 50.00 3 0.00
23 Type I hood -
- X 10.00 = 0.00
24 Type II hood
25 Heat pump/air conditioner 0-3 tons 1 X 12.00 12.00
26 Alt conditioner
3-15 tons X 20.00` = 0.00
X 25.00 0.0027 Air conditioner 15-30 tons
28 Air conditioner
304 ,0 tons X 35.00 Q 0.00
29 Air conditioner +50 tons X 60.00 = 0.00
30 LPG storage tunic - X 10.00 = 0.00
31 Wood or fsuet atoveefnsen - , X 10.00 _ 0.00
32 Wood stove-free standing - X 25.00, -- 0.00
0 Cash 0 Check 0 Visa D MasterCard Subtotal
12.00
Faxed permits will only be accepted with payment of a major credit card Plus Processing
Fee 35.00
Date: Expires: Total Permit Fee
Due 47.00
Bankcard Number. 1.
Authorized Signature:
TO/T0 39tid SNI1V3H eld SOS 11781760S 60:ST V00Z/17Z/90