2005, 07-27 Permit App: 05002623 Sewer ReversalPLUMBING. PERMIT APPLICATION
Phone: (509) 688-0036; FAX: (50`$) 683-0037
For Inspections, Call (509) 688-0054
Project Address: Permit Use:
Owner.
Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone (Daytime Contact):
Mailing Address:
State Zip Code
Phone #:
Contractor.
Mailing Address:
City
License #:
City
State
Zip Code
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
R OF UNITS
X
COST .
=
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
56.00
=
2
URINALS
-
X
56.00
=
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
56.00
=
6
DISHWASHER
X
56.00
=
7
CLOTHES WASHER
X
$6.00
=
8
GARBAGE DISPOSAL
X
$6.00
=
9
WATER SOFTENER
X
56.00
=
10
ELECTRIC HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
$6.00
=
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
X
56.00
=
12
ROOF DRAINS/OVERFLOW
DRAINS
X
$6.00
=
13
FOUNTAINS, DRINKING
X
56.00
=
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
- NSTALLATI ALTERA N. REPAIR,
REVERSAL
1
X
56.00
=
15
SEWAGE EJECTOR
X
56.00
=
GRINDER, SUMP PUMP
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER, HOSE 81B,
STEAMER
PROOFER, CARBONATOR SWAMP COOLER
X
56.00
=
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
56.00
=
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
.$6.00
=
20
MISCELLANEOUS PLUMBING
FIXTURE
X
$6.00
=
21
PRIVATE SEWAGE DISPOSAUSYS
X
$20.00
=
22
INDUSTRIAL WASTE
INTERCEPTOR
X
515.00
=
METHOD OF PAYMENT:
0 CASH 0 CHECK
DATE
-
SUBTOTAL
0 VISA 0 MASTERCARD
PROCESSING FEE
535.00
EXPIRES:
TOTAL PERMIT FEE DUE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
Sikkane
Hey
Project Address:
Owner.
MECHANICAL PERMIT APPLICATION 2(€73 Community Development Department
LE Building Division
Phone: (509) 688-0036; FAX: (509;'688-:1037�t 11707 E. Sprague Avenue, Suite 106
4 For Inspections, Call (509) 688-0054 / ( Oa . Spokane Valley, WA 99206
Permit Use:
if 7 d2-2-- L.' 0.0.14.44
Mailing Address:
Contractor.
Phone (Daytime Contact):
Mailing Address:
7Lev
License #:
City
State
Phone #:
Zip Code
0
State
Zip Code
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
X
$12.00
=
2
FUEL BURNING APPLIANCE •
More than 100,000 . ,
X
515.00
=
3
UNLISTED APPLIANCE (Additional Fee)
Equal to or less than 400,000
X
$50.00
=
4
UNLISTED APPLIANCE (Additional Fee)
- More than 400,000
X
$100.00
=
5
USED APPLIANCE (W SEC min. AFUE rating)
Equal to or less than 400.000
X
150.00
=
6
USED APPLIANCE (W SEC min. AFUE rating)
More than 400,000
X
$100.00
=
7
BOILER/REFRIGERATION
1 - 100M BTU
X
$12.00
=
8
BOILER/REFRIGERATION
101 - 500M BTU
X
$20.00
9
BOILER/REFRIGERATION
501 - 1,000M BTU
X
$25.00
=
10
BOILER/REFRIGERATION
1,001 - 1,750M BTU
X
835.00
=
11
BOILER/REFRIGERATION
More than 1,750M BTU
X
$60.00
=
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
512.00
=
21
AIR HANDLER (DOES NOT include ducting)
Greater than 10,000 CFM
X
515.00
=
22
EVAPORATIVE COOLERS
X
110.00
=
23
TYPE I HOOD
X
150.00
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
520.00
27
AIR CONDITIONER
15-30 TON
X
125.00
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
110.00
32
WOOD STOVE - FREE STANDING
X
525.00
=
33
REPAIR & ADDITIONS
X
$15.00
34
VENTILATION SYSTEMS -
X
512.00
=
35
VENTILATION MECHANICAL EXHAUST
X
$12.00
=
36
INCINERATOR - RESIDENCE
X
$19.00
=
37
INCINERATOR -COMMERCIAL
X
522.00
=
METHOD OF PAYMENT:
0 CASH 0 CHECK 0 VISA 0 MC
CARD #:
DATE:
SUBTOTAL
PROCESSING FEE
$35.00
- EXPIRES:
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE: