2004, 02-13 Permit Application: BLD-04-03554 Water PipingMETHOD 0
❑ CASH
S oka.ne
. 0.0 Valley
Plumbing Permit Application
11707 East Sprague Aver ue, Suite 106 509 - 688 -0036 - Phone
Spokane Valley, WA 99206 509 - 688 -0037 - Fax
For Inspections, call 509 - 688 -0054
PROJECT
ADDRESS: q y F f / 1
PERMIT
USE:
DETAILS
OWNER: Gairr, lit. L 1 U 1 W i,(
PHONE (Daytime Contact): it //1
COST
MAILING ADDRESS: / 4
q C/ 0 Y C . 40 Ati) WO—
6 /C3i'
O &
(street) (city /state) (ZIP)
TOILETS
CO I QR: /,, a- / "-Alt /6 i n
LICENSE #:
$6
MAILING ADDRESS:
3 L/ i. S. d� �
PHONE #: _
q l s �l
URINALS
(street) (city/state) (ZIP)
$6
PLUMBING FIXTURES
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTION
DETAILS
# OF UNITS
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
$25
-
18
INTERCEPTORS
GREASE TRAP, SAND TRAP, CHEMICAL
HOLDING TANK
X
_
19
MEDICAL GAS per outlet
NITROUS, OXYGEN
X
$6
=
20
MISC. PLUMBING FIXTURE
X
$6
=
PAYMENT
] CHECK
MEM
VISA' lfs., ,;:�
SUBTOTAL:
PLUS PROCESSING FEE:
$35.00
• •
__._..__, . "_
TOTAL PERMIT FEE DUE:
-r
a
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
Iltl�
*lane
..001rValley
Mechanical Permit Application
11707 East Sprague,Avenue, Suite 106 509- 688 -0036 - Phone
Spokane Valley, WA 99206 509 - 688 -0037 - Fax
For Inspections, call 509 - 688 -0054
PROJECT
ADDRESS:
DESCRIPTION OF WORK
PERMIT
USE:
OWNER:
X
PHONE (Daytime Contact):
MAILING ADDRESS:
AMOUNT
(street)
(city /state) (ZIP)
CONTRACTOR:
LICENSE #:
MAILING ADDRESS:
-
PHONE #:
2
(street)
(city/state) (ZIP)
X
METHOD OF PA
❑ CASH ❑ C
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
8 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
$50
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
s95
=
12
GAS LOG, GAS INSERT, GAS FIREPLACE
-
X
$10
=
13
RANGE
--
X
$10
=
14
DRYER
-
X
$10
=
15
FUEL BURNING WATER HEATER
--
X
$10
-
16
MISC. FUEL BURNING APPL.
-
X
$10
=
17
GAS PIPING (ea. Outlet)
-
X
$1
18
DUCT SYSTEMS
-
X
$10
-
19
VENTILATING FANS
-
X
$10
20
AIR HANDLER (DOES NOT include ducting)
= OR < 10,000CFM
X
$12
=
21
AIR HANDLER (DOES NOT include ducting)
> 10,000 CFM
X
$19
=
22
EVAPORATIVE COOLERS
-
X
$10
=
23
TYPE I HOOD
-
X
$50
=
24
TYPE II HOOD
--
X
$10
=
25
HEAT PUMP /AIR CONDITIONER
0 -3 TON
X
$12
26
AIR CONDITIONER
3-15 TON
X
$20
27
AIR CONDITIONER
15-30 TON
X
$25
=
28
AIR CONDITIONER
30 -50 TON
X
$35
=
29
AIR CONDITIONER
+50 TON
X
$60
30
LPG STORAGE TANK
-
X
$10
=
31
WOOD OR PELLET STOVE/INSERT
-
X
$10
=
32
WOOD STOVE - FREE STANDING
-
X
$25
=
VIENT
VISA' t i -: +c,: • •.,`
SUBTOTAL:
PLUS PROCESSING FEE:
$35.00
TOTAL PERMIT FEE DUE:
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: