2005, 03-31 Permit App: 05001029 Plumbing FixturesProject Address:
Owner:
Mailing Address:
/9C
PLUMBING PERMIT APPLICATION
Phone: (509) 688 -0036; FAX: (509) 688 -0037
For Inspections, Call (509) 688 -0054
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Permit Use:
Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone (Daytime Contact):
0
State Zip Code
Phone #:
Contractor:
City
License #:
Mailing Address:
Zip Code
City
State
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
* OF UNITS
X
. COST '
= TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS'
/
X
$6.00 •
= LI?e
Cp
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
=
LO= 6)
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
NSTALLATION, ALTERATION, REPAIR,
• REVERSALS
1
X
$6.00
= ` COO
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
=
21
PRIVATE SEWAGE DISPOSALJSYS
X
$20.00
=
22
INDUSTRIAL WASTE
INTERCEPTOR
X
$15.00
=
`
•
METHOD OF PAYMENT:
❑ CASH ❑/ CHECK ❑ VISA ❑ MASTERCARD
DATE: �,J/ ' 6 J EXPIRES:
SUBTOTAL
PROCESSING FEE ..$3355..00,
TOTAL PERMIT FEE DUE: ,� ^Z'] ''Q 1
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
Project Address:
Owner:
Mailing Address:
State
MECHANICAL PERMIT APPLICATION
Phone: (509) 688 -0036; FAX: (509) 688 -0037
For Inspections, Call (509) 688 -0054
Community Development Departmen
Building Divisior
11707 E. Sprague Avenue, Suite 10E
Spokane Valley, WA 9920E
Permit Use:
Phone (Daytime Contact):
Contractor: License #:
Mailing Address:
City
Phone #:
Zip Code
c
State
Zip Code
IZED SIGNATURE:
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
X
$t2.00
=
2
FUEL BURNING APPLIANCE
More than 100,000
X
515.00
=
3
UNLISTED APPLIANCE (Additional Fee)
Equal to or less than 400,000
X
550.00
=
4
UNLISTED APPLIANCE (Additional Fee)
More than 400,000
X
5100.00
=
5
USED APPLIANCE (WSEC min. AFUE rating)
Equal to or less than 400,000
X
550.00
=
6
USED APPLIANCE (WSEC min. AFUE rating)
More than 400,000
X '
5100.00
=
7
BOILER/REFRIGERATION
1 - 100M BTU
X
512.00
=
8
BOILER/REFRIGERATION
101 - 500M BTU
X
520.00
9
BOILER/REFRIGERATION
501 - 1,000M BTU
X
525.00
=
10
BOILER/REFRIGERATION
1,001 - 1,750M BTU
X
535.00
=
11
BOILER/REFRIGERATION
More than 1,750M BTU
X
560.00
=
12
GAS LOG, GAS INSERT, GAS FIREPLACE
-
X
• 510.00
=
13
RANGE
X
510.00
=
14
DRYER
X
510.00
=
15
FUEL BURNING WATER HEATER
X
510.00
=
16
MISC. FUEL BURNING APPLIANCE
X
510.00
=
17
GAS PIPING (each outlet)
X
$1.00
=
18
DUCT SYSTEMS
X
510.00
=
19
VENTILATING FANS
X
510.00
=
20
AIR HANDLER (DOES NOT include ducting)
Equal to or less than 10,000 CFM
X
512.00
=
21
AIR HANDLER (DOES NOT include ducting)
Greater than 10,000 CFM
X
515.00
=
22
EVAPORATIVE COOLERS
X
510.00
=
23
TYPE I HOOD
X
550.00
=
24
TYPE II HOOD
X
510.00
=
25
HEAT PUMP /AIR CONDITIONER
0-3 TON
X
512.00
=
26
. AIR CONDITIONER
3 -15 TON
X
520.00
=
27
AIR CONDITIONER
15 -30 TON
X
525.00
=
28
AIR CONDITIONER
30 -50 TON
X
535.00
=
29
AIR CONDITIONER
More than 50 TON
X
560.00
=
30
LPG STORAGE TANK
X
510.00
=
31
WOOD OR PELLET STOVE/INSERT
X
510.00
=
32
. WOOD STOVE - FREE STANDING
X
525.00
=
33
REPAIR & ADDITIONS
X
515.00
=
34
VENTILATION SYSTEMS
X
512.00
=
35
VENTILATION MECHANICAL EXHAUST
X
512.00
=
36
INCINERATOR - RESIDENCE 2
X
519.00
=
37
INCINERATOR - COMMERCIAL
X
522.00
=
METHOD OF PAYMENT:
❑ CASH ❑ CHECK ❑ VISA ❑ MC
CARD #:
DATE.
SUBTOTAL
PROCESSING FEE
535.00
EXPIRES:
TOTAL PERMIT FEE DUE:
IZED SIGNATURE: