2006, 09-18 Permit: 06003690 Plumbing, Mechanical Fixtures Spokane ---- 11707 E Sprague Ave,Suite 106 •
•
Valley Spokane Valley,WA 99206 PERI✓i11 I�-UMBER.
(509)588-0836 FAX:(509)688-0837 -
Community Development w c;1v.sDokanevallev.o-a PERMIT FEE: _
P1umbin Permit Application •- _ g pp-7 � PI Commercial []`Residential
SITE ADDRESS: _ 7 '2. (' L P I ,
Building Owner 6 1 e7 -Q r L; e
•
Name: • Phone:
Address: B 71 (2, /: L,J�, �' City: 5 R, d,j Fi State: , rj Zip: `'-"f y2/c2.
Contractor C 1 d!
Name: Phone: Fax:
Address: City: State: Zip:
License No: City Business Lic:
Name: Phone:
DESCRIPTION OF WORK #OF UNITS X 1 COST = TOTAL AMOUNT
1 TOILETS WATER CLOSET,BIDETS •IS X $6.00 = I r,/
2 URINALS X $6.DD = _
3 TUBS ,
_� X $6.DD =
4 SHOWERS(PER TRAP) BATH,STALL ON-SITE BUILT X $6.00 =
LAVS/BASINS,BAR,FLOOR,KITCHEN,
5 SINKS LAUNDRY,UTILITY,JANITOR,PHOTO, X $6.00 =
X-RAY,FOOD,PREP/CULINARY MEAT
6 DISHWASHER d X $6.00 =
7 CLOTHES WASHER X $6.00 =
8 GARBAGE DISPOSAL X $6.00 =
9 WATER SOFTENER X $6.00 =
10 ; ELECTRIC HOT WATER TANK NOTE: IF GAS,SEE MECHANICAL 1 X $6.00 =
AREA CASE,COIL TRENCH,
11 FLOOR DRAINS CONDENSATE X $6.00 =
12 ROOF DRAINS/OVERFLOW DRAINS X $6.00 = _
13 FOUNTAINS,DRINKING X $6.00 =
rr---- WATER PIPING/DRAIN-N WASTE, NSTALLATION,ALTERATION,REPAIR, _
14 VENT,PLUMBING,REVERSAL REVERSALS X $6.00 =
15 SEWAGE EJECTOR GRINDER,SUMP PUMP X $6.00 =
ICE AN/OR COFFEE MAKER,HOSE BIB,
16 WATER USING DEVICE STEAMER X $6.00 =
PROOFER,CARBONATOR,SWAMP
COOLER
VACUUM BREAKER,CHECK VALVE,
AND R.P.B.P.D.FOR: VATS,TANKS,
17 CROSS CONNECTION DEVICE BOILERS X $6.00 =
GREASE TRAP,SAND TRAP,
18 INTERCEPTORS CHEMICAL HOLDING TANK X $6.08 =
19 MEDICAL GAS(per outlet) NITROUS,OXYGEN X $6.00 =
20 MISCELLANEOUS PLUMBING FIXTURE X $6.00 =
21 PRIVATE SEWAGE DISPOSAL/SYS X $20.00 =
22 INDUSTRIAL WASTE INTERCEPTOR X $15.00 =
METHOD OF PAYMENT: SUBTOTAL c bo
PROCESSING FEE lift
OCASH (,!!"CHECK ❑VISA ❑MC EXPIRES: $35.00
Card# VIN: TOTAL PERMIT FEE DUE: QO
AUTHORIZED SIGNATURE:
REVISED 5/26/05
Sne
p 11707 E Sprague Ave,Suite 106
,.:,,,,„.. Valley Spokane Valley,WA 99206 PERMIT NUM3ER
(509)658-0036 FAX:(509)558-0037
Community Development r
t u� .sookanevallev.0 r e PERMIT FEE:
Mechanical Permit Application I I Commercial [ I Residential
SITE ADDRESS: '
Building Ovl'ner -
Name: Phone: Fax:
Address: City: State: Zip:
ConiTactor:. _
Name: Phone: Fax:
Address: City: State: Zip:
License No: City Business Lic:
Name: Phone:
DESCRIPTION OF WORK #OF UNITS X COST = TOTAL AMOUNT
1 FUEL BURNING APPLIANCE Equal to or less than 100,DOD _ X $12.00 =
2 FUEL BURNING APPLIANCE More than 100,009 X $15.00 =
3 UNLISTED APPLIANCE(Additional Fee) Equal to or less than 400,000 X $50.00 =
4 UNLISTED APPLIANCE(Additional Fee) More than 400,000 X $100.00 =
5 USED APPLIANCE(WSEC min.AFUE rating) Equal to or less than 400,000 X $50.00 =
6 USED APPLIANCE(WSEC min.AFUE rating) More than 400,000 X $1DD.DD =
7 BOILER/REFRIGERATION 1-10DM BTU X $12.00 =
B BOILER/REFRIGERATION 101-50DM BTU X $20.00 =
9 BOILER/REFRIGERATION 501-1,000M BTU X $25.00 =
10 BOILER/REFRIGERATION 1,001-1,750M BTU X $35.00 =
11 BOILER/REFRIGERATION More than 1,750M BTU X $50.00 = ,
12 GAS LOG,GAS INSERT,GAS FIREPLACE X _ $10.00 =
13 RANGE X $10.00 =
14 DRYER 1 X $10.00 =
15 FUEL BURNING WATER HEATER X $10.00 =
16 MISC.FUEL BURNING APPLIANCE X $10.00 =
17 GAS PIPING(each outlet) X $1.00 =
18 DUCT SYSTEMS X $10.00 =
19 VENTILATING FANS X $10.00 =
20 AIR HANDLER(DOES NOT include ducting) Equal to or less than 10,000 CFM X $12.00 =
21 AIR HANDLER(DOES NOT include ducting) Greater than 10,00D CFM X $15.00 =
22 EVAPORATIVE COOLERS X $10.00 .._ _
23 TYPE I HOOD X $50.00 =
24 TYPE II HOOD X $10.00 =
25 HEAT PUMP/AIR CONDITIONER 0-3 TON X $12.00 =
26 AIR CONDITIONER 3-15 TON X $20.00 =
27 AIR CONDITIONER 15-30 TON X $25.00 =
2B AIR CONDITIONER 30-50 TON X $35.00 =
29 AIR CONDITIONER More than 50 TON X $50.00 =
3D LPG STORAGE TANK X $10.00 =
31 WOOD OR PELLET STOVE:/INSERT X $10.00 =
32 WOOD STOVE FREE STANDING X $25.00 =
33 REPAIR&ADDITIONS X $15.00 =
34 VENTILATION SYSTEMS X $12.00 =
35 VENTILATION MECHANICAL EXHAUST X $12.00 =
36 INCINERATOR-RESIDENCE _ X $19.00 =
37 INCINERATOR-COMMERCIAL X $22.00 =
METHOD OF PAYMENT: SUBTOTAL '3'1°,4:.'e.
['CASH ❑CHECK ❑VISA 0 MC EXPIRES: PROCESSING FEE $35.00
CARD#. VIN: TOTAL PERMIT FEE DUE: 5j C.:
AUTHORIZED SIGNATURE: " '
REVISED 6!26!D5