2003, 11-19 Permit App: BLD-03-03104 Mechanical Fixture1
S ioliane
,r, •i Valley
Mechanical Permit Application
11707 East Sprague Avenue, Suite 106 509 - 688 -0036 - Phone
509 - 688 - 0037 - Fax
Spokane Valley, WA 99206
METHOD
❑ CASH
1,-, J Cl._ 1
ADDRESS: a 7 1 L( P, /3(; S t' ) If\
OWNER:
PERMIT
USE:
T 1'It. /Soy) ",''5 r (AC�
d l~ 17
PHONE (Daytime Contact): ( , - 3
S C °I �t
MAILING ADDRESS: .3
i✓ 7c U B \4t,t), n
(street) (city /state) ZIP 19 al -
°am; W�, . ( )
CONTRACTOR:
LICENSE #:
MAILING ADDRESS:
PHONE #:
(street) (city /state) (ZIP)
DESCRIPTION OF WORK
tt OF UNITS
X
COST
EQUALS
AMOUNT
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
$95
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)
-
i
X
$1
18
DUCT SYS16MS
-
X
$10
19
VENTILATING FANS
-
X
$10
20
AIR HANDLER (DOES NOT include ducting)
- OR < 10,000CFM
X
512
-
21
AM 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
560
-
30
LPG STORAGE TANK
-
X
$10
-
31
WOOD OR PELLET STOVE/INSERT
-
X
510
-
32
WOOD STOVE - FREE STANDING
-
X
525
.
OF PAYMENT
SUBTOTAL:
PLUS PROCESSING FEE:
$35.00
VISA I � .- .' .
TOTAL PERMIT FEE DUE:
DATE:
EXPIRES:
BANKCARD NUMBER
AUTHORIZED SIGNATURE:
[ETHOD OF
] CASH
ATE:
crrt cx
Spokane
... Valley
11707 East Sprague Avenue, Suite 106 509 - 688 -0036 Phone
Spokane Valley, WA 99206
509 - 688 -0037 - Fax
Plumbing Permit Application
PLUMBING FIXTUR
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) (LIP)
PLUMBING FIXTUR
ANKCARD NUMBER:
UTHORIZED 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 SOB 1 bNER
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
3 CHECK
VGA"
NasA-- ' _
._ __. - _
SUBTOTAL:
PLUS PROCESSING FEE:
-
$35.00
• =MU •
1 V T)TD FC.
TOTAL PERMIT FEE DUE:
ANKCARD NUMBER:
UTHORIZED SIGNATURE: