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2004, 07-20 Permit App BLD-04-07115 AC
TO.39d SOST1781260S LS : T T P00E 90 rnr City of Spokane Valley Mechanical Permit Application Fax # 688-0037 Project Address: 10528 E Broadway Permit Use: Owner, John Ward Phone (daytime contact): 891-7075 Mailing Address: SAME (street) Contractor. R&R Heating and AC, Inc. (city/slate) License: RRHEAA106BW (zip) Mailing Address: 4019 E Central Spokane. Wa 99217 (street) Description of Work 1 Fuel burning appliance 2 Fuel burning appliance 3 Unlisted appliance (additional charge) 4 Unlisted appliance (additional charge) 5 Used appliance (WSEC's min. AFUE rating) 6 Used appliance (WSEC's min. AFUE rating) 7 Boiler/refrigeration 8 Boiler/refrigeration 9 Boiler/refrigeration 10 Boller/refrigeration 11 Boller/refrigeration 12 Gas lop. gas insert, gas fireplace 13 Range 14 Dryer 15 Fuel burning water heater 16 Miscellaneous fuel burning appliance 17 Gas piping, (each outlet) 18 Duct systems 19 Ventilating fans 20 Air handler (does not include ducting) 21 Air handler (does not include ducting) 22 Evaporatlt: coolers 23 Type 1 hood 24 Type II hood 25 Heat pump/air conditioner 26 Air conditioner 27 Air conditioner - or < 100,000 > 100,000 - or < 400,000 > 400.000 - or < 100,000 > 400,000 1-100M BTU 101-500M BTU 501-1,000M BTU 1,001-1,750M BTU + 1,750M BTU - or < 10.000 CFM > 10,000 CFM 0-3 tons 3-15 tons 15-30 tons 30-50 tons 28 Air conditioner 29 Air conditioner 30 LPG storage tank 31 32 Wood stove - free stendlnj ❑ Cash 0 Check 0 Visa 0 MasterCard Faxed permits wifl only be accepted with payment of a major credit card ✓ Date: f (P 0 ` at Expires: +� 1 0 Bankcard Number. Authorized Signature: Wood or pellet stove/Insert + 50 tons Phone-4: 484-1405 (city/state) # of units 1 x x x x x x x x x Cost 15.00 19.00 50.00 100.00 580.00 100.00 15.00 28.00 39.00 57.00 95.00 10.00 10.00 10.00 10.00 10.00 1.00 10.00 10.00 12.00 19.00 10.00 50.00 10.00 12.00 20.00 25.00, 35.00 60.00 10.00 10.00 25.00 c r< (zip) Subtotal Plus Processing Fee Total Permit Fee Due Amount 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 12.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 12.00 35.00 47.00 TO/TO E9Cd 9NIIC8H dd S2STb812605 bb:iI b00E/90/L0