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2003, 11-20 Permit App: BLD-03-03123 Furnace 11/19/2003 17:50 5094841505 RR'HEATING PAGE 01/01 City of Spokane Valley Mechanical Permit Application Fax#688-0037 C,i3 �/ 3 Project Permit Address: 11815 E 38th Use: Owner: Donna Scott Phone(daytime contact): 891-2806 Mailing Address SAME (street) Scity/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) (gyp) Description of Work #of units Cast = 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 101-500M BTU X 28.00 = , 0.00 501-1,000M BTU X 39.00 0.00 9 Boiler/refrigeration - 10 Boiler/refrigeration 1,001-1,750M BTU X 57.00 = , 0.00 11 Boller/refrigeration + 1,75QM 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 = 0.00 18 Duct systems - X 10.00 = 0.00 19 Ventilating fans - X 10.00 = 0.00 20 Air handler cdoes 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 15-30 tons X 25.00, = 0.00 28 Air conditioner 30-50 tons X 35.00 = 0.00 29 Air conditioner I.50 tons _ X 60.00 = 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 _ - - 0.00 0 Cash 0 Check 0 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: I(j 1 q/ 0 3- Expires: Total Permit Fee Due 50.00 Bankcard Number. , Authorized Signature: p_________________------- NOV 16 2003 17:01 5094841505 PAGE.01