2004, 02-12 Permit App: BLD-04-03547 Water PipingS`�okane .
Walley
Mechanical Permit Application
11707 East Sprag:e Avenue, Suite 106 509-688-0036 Phone
Spokane Valley, WA 99206 509-688-0037 - Fax
For Inspections, call 509-688-0054
PROJECT ler 7 n) OF -55 l r5:- 14V7 r
ADDRESS: J".9,23/ �Qi-LFj
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2/Z
PERMTTt I. - <-1c.i 1 Ai d1 t - .C? - ) 7-4'
USE: 4-,t, -71/14-7`.. G�i3C5.7-1> 34 JFie.
E_
OWNER: " A4 /Aid
j
rS (
COST
PHONE (Daytime Contact):
AMOUNT
MAILING ADDRESS: i
4r7.a 55 ,_
5
,-
Jr: 0 IF ed
2/2 —
(street)
` (city/state)
(ZIT)
CONTRACTOR: F
FUEL BURNING APPLIANCE
> 100,000
LICENSE 1:
X
MAILING ADDRESS:
-
Pfj�N„ E A; .3 7s�
UNLISTED APPLIANCE (ADDITIONAL FEE)
• OR <400,000
(street)
(city/state)
(ZIP)
METHOD OF PA
0 CASH
❑ CHECK
DATE:
EXPIRES:
BANKCARD NUMBER
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
# OF UNITS
X
COST
EQUALS
AMOUNT
1
FUEL BURNING APPLIANCE
• OR < 100,000
X
515
-
2
FUEL BURNING APPLIANCE
> 100,000
X
519
-
3
UNLISTED APPLIANCE (ADDITIONAL FEE)
• OR <400,000
X
550
-
4
UNLISTED APPLIANCE (ADDITIONAL FEE)
> 400,000
X
5100
•
5
USED APPLIANCE (WSEC min AFUE rating)
- or <400,000
X
550
•
6
USED APPLIANCE (WSEC min. AFUE rating)
> 400,000
X
5100
-
7
BOILER/REFRIGERATION
1 -100M BTU
X
515
•
8
BOILER/REFRIGERATION
101- 500M BTU
X
$2.8
•
9
BOILER/REFRIGERATION
501 - 1,000M BTU
X
$39
-
10
BOILER/REFRIGERATION
1001 - 1,750M BTU
X
557
-
11
BOILER/REFRIGERATION
#1750M BTU
X
595
•
12
GAS LOG, GAS INSERT, GAS FIREPLACE
-
X
510
-
13
RANGE
-
X
510
-
14
DRYER
-
X
510
•
15
FUEL BURNING WATER HEATER
--
X
510
•
16
MISC. FUEL BURNING APPL.
-
X
510
•
17
GAS PIPING (ea Outlet)
-
X
Si
-
18
DUCT SYSTEMS
-
X
510
-
19
VENTILATING FANS
--
X
510
•
20
AIR HANDLER (DOES NOT include ducting)
• OR < 10,000CFM
X
512
•
2I
AIR HANDLER (DOES NOT include ducting)
> 10,000 CFM
X
519
•
22
EVAPORATIVE COOLERS
-
X
510
•
-
23
TYPE I HOOD
-
X
$50
-
24
TYPE II HOOD
-
X
513
•
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
X
512
•
26
AIRCOND[TIONER
3-15 TON
X
520
•
27
AIR CONDITIONER
15-30 TON
X
525
•
28
AIR CONDITIONER
30-50 TON
X
535
•
29
AIR CONDITIONER
+SO TON
X
560
•
30
LPG STORAGE TANK
-
X
510
•
3I
WOOD OR PELLETSTOVE/INSERT
-
X
510
•
32
WOOD STOVE - FREE STANDING
-
X
525
•
MENTPLUS
I_ _
=MI
VISA' .
SUBTOTAL:
PROCESSING FEE:
$35.00
TOTAL PERMIT FEE DUE:
❑ CHECK
DATE:
EXPIRES:
BANKCARD NUMBER
AUTHORIZED SIGNATURE:
METHOD OF
❑ CASH
DATE:
*lane
Valley
Plumbing 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
35`1
PROJECT
ADDRESS:
DESCRIPTION
PERMIT
USE:
OWNER:
X
PHONE (Daytime Contact):
MAILING ADDRESS:
AMOUNT
(street)
(city/state) (ZIP)
CONTRACTOR
LICENSE 1/:
MAILING ADDRESS:
-
PHONE #:
2
(street)
(city/state) (ZIP)
PLUMBING FIXTURES
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTION
DETAILS
# OF UNITS
X
COST
EQUALS
AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
$6
-
2
URINALS
X
16
-
3
TUBS
X
$6
-
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
X
$6
-
5
SINKS
LAVS/BASINS, 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
16
-
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-1N
WASTE, VENT, PLUMBING
REVERSALair
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
86
-
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
❑ CHECK
SWIM
Maiiiiit
"J
SUBTOTAL:
PLUS PROCESSING FEE:
$35.00
■
TOTAL PERMIT FEE DUE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: