2003, 05-13 Permit: BD03-400 Mechanical FixturesMAY -13 -2003 TUE 08:36 AM SPOKANE FIREPLACE PATIO
City of
11 SPOKANE VALLEY
509 326 2842
PLUMBING /.MECHANICAL
PERMIT APPLICATION &
PLR1VIIT# 3- / z )
Contra r nform tfoa
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0x,a• e re.
Con rector's amen,
0:7 1vA
l?'tl racitr 's address
enContractor ',hone Number
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applipaVtrmapo eel
Oivn /(Name
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c ,5,0 _ x' 91- 6 - Coda
Owner phone number
Tax Parcel Number (Assessors Number)
Contractor's 'registration card (or copy) must be presented at
D ��` d � �. C-- tlma of ctrbtftlttaG
Fixture Count /Schedule of Work
Mechanical Braic fee
Number lrnrpreo (up to 100,000 btu )
Gas .riot Water Heater
Cook Top & other appliances
Clothes dryer
Converrlon burner
Gas Ingo, gra fireplace loacrt
Wood stove system
Appliance vent repstlr.- reiocattov
Laundry Maher/alai(
A/C unit ((up to 3 tons)
Vnit neater (up to 100,000 btu )
Ylrerloee heart (woAQ - pellets )
Evaporative cooler
Commercial Hood
Fathaott veins
DUcls Qyatont
Gas Piping ( outlets )
(91. for every outlet after 4)
Total
Torii
Ike Cost S
I hereby authorize thr
Mastercard N4,
S35.
515. ea
$10, ca
SI% ear
Sta.ea
$10.
510, en
$25.
57.5aea
$1l1.
S12.
�l2 ca
$10.e.a
$12. ea
81,2-
8.
$12.
$ S. up to 4 nuticts
ltat Cott $
.Plumbing
Number
Basic fee S35,
Toilets Urinals $ S. ea
Tub do flucett 9 6, ea
Shower heeds $ 6. ce
Bathroom sinks $ 6, en
Kitchen sink" $ 6. ea
bitawmoors $ 6- Ea
Rot water MO MO, ea
Linn Aprinkling system 929.
Private sewage tyttem $x01
Vacuum type breaker (5) ;26.
S6.a it
96. ca
96. ea
$ ca
$6.as
$6,311
Drinking fountains
Moor brains
Slump
fiackfiow preventor
pipc-Orainatc repair
Mae lilb
REDACTED
Print name ofholder ea. Y . % a to "
Si�rgtu
Signature of applicant
HOMEOWNER INSTALLER ONLY
1 heta:by etttlly gist 1 asn tits owner of the property dcaodbcd le this epplieatl4n, i understand that
the work b 0.b /act to ln.(Aectlon and approval by of Spokane Valley, and that ,l may not allow any
atkerperron, Including a lleserelyd caNfrarror, r4 da irny work under th11 pemtft.
TofiIk COO [? 0
Date
signature grow nee
Date
FOR OFFICE USE ONLY
bate reoelved
confidential credit card
information
This document contains CW 42.56.230 5
may pursuant to R attaining to any
and has been of our findings p Valley
for review Spokane petition documents pursuant t° p
You ay p withheld locum and obtain judicial relieve
al Code (SMC) 2.75.080;
redacted or
Municipal V
42.56.550•
pursuant to RCW
Mechanical
Bath
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