2004, 05-24 Permit App: BLD-04-04431 Plumbing ReversalSriokane\t„
.0,0Ualley
Project Address:
Owner:
50 5�YRt
MECHANICAL PERMIT APPLICATION
City of Spokane Valley Community Development Department
BuildingDivision
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
FOR INSPECTIONS, CALL (509) 688-0054
Mailing Address:
t%ty21L.t= �l iq�Arz,
✓o7 3 Fou J7.(
Permit Use:
Phone (Daytime Contact): 7�
State I ode
Contractor: ` 7-4+1F � t �q 1, .. License #:
'
Mai ing Address: �D L ( 17 /r // er(
CI p
gl L 0 Phone #: -37-c3'
CI
State
AUTHORIZED SIGNATURE:
Zip Code
DESCRIPTION OF WORK
#OF
UNITS
X
COST
=
TOTAL
AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
X
$15 00
=
2
FUEL BURNING APPLIANCE
More than 100,000
X
519.00
=
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 (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
$15.00
=
8
BOILER/REFRIGERATION
101 - 500M BTU
X
$28.00
=
9
BOILER/REFRIGERATION
501 - 1,000M BTU
X
$39 00
=
10
BOILER/REFRIGERATION
1,001 - 1,750M BTU
X
557.00
=
11
BOILER/REFRIGERATION
More than 1,750M BTU
X
595 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
$10 00
=
16
MISC. FUEL BURNING APPLIANCE
X
510 00
=
17
GAS PIPING (each outlet)
X
51.00
=
18
DUCT SYSTEMS
X
510.00
=
19
VENTILATING FANS
X
$1000
=
20
AIR HANDLER (DOES NOT Include ducting)
Equal to or less than 10,000 CFM
X
$12 00
=
21
AIR HANDLER (DOES NOT include ducting)
Greater than 10,000 CFM
X
519.00
=
22
EVAPORATIVE COOLERS
X
51000
23
TYPE I HOOD
X
55000
=
24
TYPE II HOOD
X
510.00
=
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
525.00
=
28
AIR CONDITIONER
30-50 TON
X
$35.00
=
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
=
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:
Zip Code
Sliclane
PLUMBING PERMIT APPLICATION
City of Spokane Valley Community Development Department
BuildingDivision
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
FOR INSPECTIONS, CALL (509) 688-0054
Project Address: Permit Use:
Owner: Phone (Daytime Contact):
Mailing Address:
City
State Zip Code
Contractor: License #: Phone #:
Mailing Address:
City
State
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
Zip Code
DESCRIPTION OF WORK
# OF
UNITS
X
COST
=
TOTAL
AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
$6.00
=
2
URINALS
X
$6.00
=
3
TUBS
X
$6.00
=
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
X
$6.00
=
5
SINKS
LAYS/BASINS, BAR, FLOOR,
KITCHEN, LAUNDRY, UTILITY,
JANITOR, PHOTO, X-RAY, FOOD,
PREP/CULINARY/MEAT
X
$6.00
=
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
INSTALLATION, ALTERATION,
REPAIR, REVERSALS
I
X
$6.00
=
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
=
METHOD OF PAYMENT:
❑ CASH ❑ CHECK ❑ VISA ❑ MASTERCARD
DATE: EXPIRES:
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
Zip Code