2003, 12-10 Permit Application: BLD-03-03240 Gas Log, Insert, FireplaceOTY (A:
Sp+kane
.000Valley
11707 East Sprague Avenue, Suite 106
Spokane Valley, WA 99206
509 - 688 - 0036 - Phone
509 - 688 -0037 - Fax
Mechanical Permit Application
PROJECT
ADDRESS. 1(,),_ Lt.
A / 10 n f I<
PERMIT
USE: / a s
, p •
OWNER: "3---0 s k 2
Tc y 1.4, r
PHONE (Daytime Contact):( S 0 q ) 2 1q 1 it 0..
MAILING ADDRESS:
J I s, p., l<
i o 1 - / /� z
\/P / G1. I A. (e A 'Ic 6 J 7
(street)
(city /state)
(ZIP)
CONTRACTOR:
' $15
LICENSE #:
MAILING ADDRESS: -
FUEL BURNING APPLIANCE
PHONE #:
X
$19
(street)
(city /state)
(ZIP)
METHOD OF PA
❑ CASH ,• C
DATE: 12 - 10 - 0 EXPIRES:
BANKCARD NUMBER
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
# OF UNITS
X
COST
EQUALS
AMOUNT
1
FUEL BURNING APPLIANCE
= OR < 100,000
X
' $15
-
2
FUEL BURNING APPLIANCE
> 100,000
X
$19
-
3
UNLISTED APPLIANCE (ADDITIONAL FEE)
= OR < 400,000
X
$50
=
4
UNLISTED APPLIANCE (ADDITIONAL FEE)
> 400,000
X
$100
=
5
USED APPLIANCE (WSEC min. AFUE rating)
= or <400,000
X
. 950
=
6
USED APPLIANCE (WSEC min. AFUE rating)
> 400,000
X
9100
-
7
BOILER/REFRIGERATION
1 - 100M BTU
X
$15
-
8
BOILER/REFRIGERATION
101 - 500M BTU
X
$28
-
9
BOILER/REFRIGERATION
501 - 1,000M BTU
X
$39
=
10
BOILER/REFRIGERATION
1001 - 1,750M BTU
X
$57
=
11
BOILER/REFRIGERATION
+1750M BTU
X
$95
=
12
GAS LOG, GAS INSERT, GAS FIREPLACE
-
I
X
910
-
( 0
13
RANGE
-
X
910
=
14
DRYER
-
X
910
=
15
FUEL BURNING WATER HEATER
-
X
$10
16
MISC FUEL BURNING APPL.
-
X
$10
=
17
GAS PIPING (ea. Outlet)
-
X
S1
=
a
18
DUCT SYSTEMS
-
X
910
=
19
VENTILATING FANS
-
X
910
=
20
AIR HANDLER (DOES NOT include ducting)
= OR < 10,000CFM
X
912
=
21
AIR HANDLER (DOES NOT include ducting)
> 10,000 CFM
)(
$19
=
22
EVAPORATIVE COOLERS
-
X
910
_
23
TYPE I HOOD
-
X
950
-
24
TYPE II HOOD
-
X
910
-
25
HEAT PUMP /AIR CONDITIONER
0-3 TON
X
912
-
26
AIR CONDITIONER
3.15 TON
X
$20
-
27
AIR CONDITIONER
15-30 TON
X
925
=
28
AIR CONDITIONER
30-50 TON
X
$35
-
29
AIR CONDITIONER
+50 TON
X
960
-
30
LPG STORAGE TANK
-
X
910
-
31
WOOD OR PELLETSTOVE/INSERT
-
X
910
-
32
WOOD STOVE - FREE STANDING
-
X
925
-
KENT
VISA' i -
SUBTOTAL:
I D.,00
PLUS PROCESSING FEE:
$35.00
TOTAL PERMIT FEE DUE:
47. o c
DATE: 12 - 10 - 0 EXPIRES:
BANKCARD NUMBER
AUTHORIZED SIGNATURE:
[ETHOD OF
] CASH
ATE:
lrrp,�
Spocrrt cxkane
,,, . Va11ey
11707 East Sprague Avenue, Suite 106 509 - 688 -0036 Phone
Spokane Valley, WA 99206
509-688-0037 - Fax
Plumbing Permit Application
PROJECT
ADDRESS:
DESCRIPTION
PERMIT
USE:
OWNER:
X
PHONE (Daytime Contact):
MAILING ADDRESS:
AMOUNT
(street)
(city /state) (Gll')
CONTRACTOR:
LICENSE #:
MAILING ADDRESS:
-
PHONE #:
2
(street)
(city /state) (ZIP)
PLUMBING FIXTURES
NNKCARD NUMBER
UTHORIZED SIGNATURE:
DESCRIPTION
DETAILS
# OF IIIVTTS
X
COST
EQUALS
AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
$6
-
2
URINALS
X
$6
-
3
TUBS
X
$6
-
4
SHOWERS (PER TRAP)
BATH, STALL, ON -SITE BUILT
X
$6
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO, X-
RAY, FOOD, PREP /CULINARY/MEAT
X
$6
-
6
DISHWASHER
X
$6
-
7
CLOTHES WASHER
X
$6
-
8
GARBAGE DISPOSAL
X
$6
-
9
WATER SOFTENER
X
$6
-
10
ELECT. HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
$6
-
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
X
$6_
12
FOUNTAINS, DRINKING
X
$6
-
13
WATER PIPING/DRAIN -IN
WASTE, VENT, PLUMBING
REVERSAL
INSTALLATION, ALTERATION, REPAIR,
REVERSALS
X
$6
-
14
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
$6
-
15
WATER USING DEVICE
ICE AND /OR COFFEE MAKER, HOSE BIB,
STEAMER, PROOFER, CARBONATOR,
SWAMP COOLER
X
$6
-
16
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE, AND
R.P.B.P.D. FOR: VATS, TANKS, BOILERS
X
$6
-
17
SPRINKLER SYSTEM
X
$25
-
18
INTERCEPTORS
GREASE TRAP, SAND TRAP, CHEMICAL
HOLDING TANK
X
$6
19
MEDICAL GAS per outlet
NITROUS, OXYGEN
X
$6
•
20
MISC. PLUMBING FIXTURE
X
$6
-
PAYMENT
• VISA • West
3 CHECK • • - .. -
FXPTRFC•
SUBTOTAL:
PLUS PROCESSING FEE:
$35.00
TOTAL PERMIT FEE DUE:
NNKCARD NUMBER
UTHORIZED SIGNATURE: