2004, 05-11 Permit Application: BLD-04-04323 Plumbing ReversalProject Address:
Owner:
Mailing Address:
)$g/0 4-1k,
L-
))l3lo le:
PLUMBING PERMIT APPLICATION
City of Spokane Valley Community Development Department
BuildingDivision
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688 -0036; Fax: (509) 688 -0037
FOR INSPECTIONS, CALL (509) 688 -0054
Permit Use:
Phone (Daytime Contact):
City State Zip Code
Contractor: License #: mil I� Phone #: 8
Mailing Address: 3 , y 2
CA .OBI
State
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
Zip Code
DESCRIPTION OF WORK
# OF
UNITS
X
COST
=
TOTAL
AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
$6.00
=
2
URINALS
X
$6.00
=
3
TUBS
X
$6.00
=
4
SHOWERS (PER TRAP)
BATH, STALL, ON -SITE BUILT
+
X
$6.00
=
5
SINKS
LAVS /BASINS, BAR, FLOOR,
KITCHEN, LAUNDRY, UTILITY,
JANITOR, PHOTO, X -RAY, FOOD,
PREP /CULINARY /MEAT
X
$6.00
=
6
DISHWASHER
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
X
$6.00
=
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH,
CONDENSATE
X
$6.00
=
12
ROOF DRAINS /OVERFLOW DRAINS
X
$6.00
=
13
FOUNTAINS, DRINKING
X
$6.00
=
14
WATER PIPING /DRAIN -IN WASTE,
VENT, PLUMBING, REVERSAL
INSTALLATION, ALTERATION,
REPAIR, REVERSALS
X
$6.00
=
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
$6.00
=
16
WATER USING DEVICE
ICE AN /OR COFFEE MAKER,
HOSE BIB, STEAMER, PROOFER,
CARBONATOR, SWAMP COOLER
X
$6.00
=
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK
VALVE, AND R.P.B.P.D. FOR:
VATS, TANKS, BOILERS
X
$6.00
=
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
$6.00
=
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
$6.00
=
20
MISCELLANEOUS PLUMBING FIXTURE
X
$6.00
=
METHOD OF PAYMENT:
❑ CASH ❑ CHECK ❑ VISA ❑ MASTERCARD
DATE: EXPIRES:
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
Zip Code
s&'s
��
MECHANICAL PERMIT APPLICATION
City of Spokane Valley Community Development Department
BuildingDivision
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688 -0036; Fax: (509) 688 -0037
FOR INSPECTIONS, CALL (509) 688 -0054
Project Address: Permit Use:
Owner: Phone (Daytime Contact):
Mailing Address:
Zip Code
Contractor:
Mailing Address:
License #:
City
State
Phone #:
Cit
State
AUTHORIZED SIGNATURE:
Zip Code
DESCRIPTION OF WORK
# OF
UNITS
X
COST
=
TOTAL
AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
More than 100,000
X
X
$15.00
$19.00
=
=
2
FUEL BURNING APPLIANCE
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
$100.00
=
7
BOILER/REFRIGERATION
1 - 100M BTU
X
$15.00
=
8
BOILER/REFRIGERATION
101 - 500M BTU
X
$28.00
=
9
BOILER/REFRIGERATION
501 - 1,000M BTU
X
$39.00
=
10
BOILER/REFRIGERATION
1,001 - 1,750M BTU
X
$57.00
=
11
BOILER/REFRIGERATION
More than 1,750M BTU
X
$95.00
=
12
GAS LOG, GAS INSERT, GAS FIREPLACE
X
$10.00
=
13
RANGE
X
$10.00
14
DRYER
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 10,000 CFM
X
$19.00
=
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
=
28
AIR CONDITIONER
30 -50 TON
X
$35.00
=
29
AIR CONDITIONER
More than 50 TON
X
$60.00
=
30
LPG STORAGE TANK
X
$10.00
31
WOOD OR PELLET STOVE/INSERT
X
$10.00
=
32
WOOD STOVE - FREE STANDING
X
$25.00
METHOD OF PAYMENT:
❑ CASH ❑ CHECK ❑ VISA ❑ MC
CARD #:
DATE:
SUBTOTAL
PROCESSING FEE
$35.00
EXPIRES.
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
Zip Code