2003, 12-09 Permit Application: BLD-03-03230 Unit Heating Installationc3T1 cx
,,,,,•Valley
Mechanical Permit Application
11707 East Sprague Avenue, Suite 106
Spokane Valley, WA 99206
509 - 688 -0036 - Phone
509-688-0037 - Fax
PROJECT
t-4 Q ?D N • 44...a..,41 1 S ed
DESCRIPTION OF WORK
PERMIT
USE: L.Ci% / f" h ea
lADDRESS:
//9Gj C f) S /Z(�
/
OWNER: BeLie 4_ 6 Ilea � a 4e-r ( /d
PHONE (Daytime Contact): (5ai) q99 yo v
MAILING ADDRESS:
L/ 0D ✓ y'i ,. A ci a 1175 /(�
\ /
Spol�a. Y� fl,. z, 9P/40
(street) (city /state)
(ZIP)
= OR < 100,000
CONTRACTOR: 8ct r2,2‹.-1,--, r-Lt e- /
X
LICENSE #:
-
MAILING ADDRESS:
2
PHONE #:
> 100,000
X
(street) (city/state)
(ZIP)
METHOD OF PA
❑ CASH ❑ C
DATE: EXPIRES:
BANKCARD NUMBER
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
9OFU1VITS
X
COST
EQUALS
AMOUNT
1
FUEL BURNING APPLIANCE
= OR < 100,000
X
' 915
-
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
$100
-
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
-
X
910
-
13
RANGE
-
X
910
=
14
DRYER
-
X
910
=
15
FUEL BURNING WATER HEATER
-
X
910
-
16
MISC FUEL BURNING APPL.
-
X
$10
=
17
GAS PIPING (ea. Outlet)
-
X
91
=
18
DUCT SYSTEMS
-
X
$10
=
19
VENTILATING FANS
-
X
$10
-
20
MR HANDLER (DOES NOT include ducting)
= OR < 10,000CFM
X
912
-
21
AIR HANDLER (DOES NOT include ducting)
> 10,000 CFM
X
919
■
22
EVAPORATIVE COOLERS
-
X
510
=
23
TYPE I HOOD
-
X
$50
-
24
TYPE II HOOD
-
X
510
-
25
HEAT PUMP /AIR CONDITIONER
0-3 TON
X
$12
=
26
AIR CONDITIONER
3-15 TON
X
920
-
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
$10
-
31
WOOD OR PELLET STOVE/INSERT
-
X
' $10
=
32
WOOD STOVE - FREE STANDING
-
X
925
-
1{ENT
r P ,
SUBTOTAL:
PLUS PROCESSING FEE:
$35.00
TOTAL PERMIT FEE DUE:
DATE: EXPIRES:
BANKCARD NUMBER
AUTHORIZED SIGNATURE:
[ETHOD OF
] CASH
ATE:
.NKCARD NUMBER:
IUTHORIZED SIGNATURE:
Spokane `
,,,,•Valley
Plumbing Permit Application
11707 East Sprague Avenue, Suite 106 509 - 688 -0036 Phone
Spokane Valley, WA 99206
509 - 688 -0037 - Fax
PROJECT
ADDRESS:
DESCRIPTION
PERMIT
USE:
OWNER:
X
PHONE (Daytime Contact):
MAILING ADDRESS:
AMOUNT
(street)
(city /state) (ZIP)
CONTRACTOR:
LICENSE #:
MAILING ADDRESS:
-
PHONE #:
2
(street)
(city/state) (ZIP) .
PLUMBING FIXTURES
DESCRIPTION
DETAILS
# OF UNTTS
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
LAVSBASINS, 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
825
-
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
3 CHECK
tifzs1.- " :
.__., .
SUBTOTAL:
PLUS PROCESSING FEE:
$35.00
❑ SUM= •
t•vrr n Tr
TOTAL PERMIT FEE DUE: