2005, 08-22 Permit App: 05003058 Gas InsertPLUMBING PERMIT APPLICATION Community Development Department
Azi� Building Division
Phone: (509) 688-0036; FAX: (509) 688-0037 11707 E. Sprague Avenue, Suite 106
l For Inspections, Call (509) 688-0054 r. �, �-� Spokane Valley, WA 99206
Project Address: 17110 >E l/�hy�i�P l� �1i/ Permit Use:
Owner. Phone Daytime Contact): 121- 9W — vl�p
�, 17th /�G
Mailing Address: _ 267, k X Al
City State Zip Code
Contractor. L.> v' &
Mailing Address:
License #:
City
Phone #:
State Zip Code
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
9 OF UNITS
X
COST
=
TOTAL AMDUNT
1
TOILETS
WATER CLOSET, BIDETS
X
$6 -DO
=
2
URINALS
X
$5.00
=
3
TUBS
X
$6.00
=
4
SHOWERS PER TRAP
BATH, STALL, ONSITE BUILT
X
$6.OD
-
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
X
$6.OD
=
6
DISHWASHER
X
$6.00
=
7
CLOTHES WASHER
X
$6.00
=
B
GARBAGE DISPOSAL
X
56.0D
=
9
1NATER SOFTENER
X
S6.DD
=
10
ELECTRIC HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
$6.0D
=
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
X
$6.OD
=
12
ROOF DRAINS/OVERFLOW
DRAINS
X
$6.00
=
13
FOUNTAINS, DRINKING
X
$6.00
=
14
WATER PIPING/DRAIWIN WASTE,
VENT, PLUMBING, REVERSAL
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
X
$6.OD
=
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
$6 -DO
=
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER, HOSE BIB,
STEAMER
PROOFER, CARBONATOR, SWAMP COOLER
X
$5.00
=
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE,
AND R.P.B.P.D. FOR: VATS, TANKS, BOILERS
X
$6.OD
=
1B
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
$6.DD
=
19
MEDICAL GAS r outlet)
NITROUS, OXYGEN
X
$6.0D
=
20
MISCELLANEOUS PLUMBING
FIXTURE
X
$6. DO
=
21
PRIVATE SEWAGE DISPOSAUSYS
X
$20.OD
=
22
INDUSTRIAL WASTE
INTERCEPTOR
X
$15.DD
=
METHOD OF PAYMENT:
ElCASH ❑ CHECK ❑ VISA ElMASTERCARD
DATE: EXPIRES:
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
MECHANICAL PERMIT APPLICATION- _�� Community Development Department
Building Division
�L Phone: (509) 688-0036; FAX: (509) 688-0037 11707 E. Sprague Avenue, Suite 106
' For Inspections, Call (509) 688-0054 `X Spokane Valley, WA 99206
Project Address:
Owner. P -ma
Mailing Address:
Contractor: Ips" /y leyey License #:
Mailing Address:
„aerm;lit Use:
, Phone'(P4.y ime Contact):
City
Phone #:
Code
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
# OF UNITS X
COST = TOTAL AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 1 D0,000
X
$12.00 =
2
FUEL BURNING APPLIANCE
More than 100,0DO
X
$15.00 =
3
UNLISTED APPLIANCE Additional Fee
Equal to or less than 4DO,ODD
X
$50.DO =
4
U14LISTED APPLIANCE Addifional Fee
More than 400,D00
X
$100.00 =
5
USED APPLIANCE SEC min. AFUE ratio
Equal to or less than 400,DDD
X
$50.00 =
6
USED APPLIANCE SEC min. AFUE rafin
More than 400,000
X
$100.00 =
7
BOILER/REFRIGERATION
1 - 1DOM BTU
X
$12.00 =
8
BOILER/REFRIGERATION
101 - 5ODM BTU
X
$2D.00 =
9
BOILER/REFRIGERATION
5D1 - 1,OODM BTU
X
$25.00 =
10
BOILER/REFRIGERATION
1,001 - 1,750M BTU
X
$35.DD -
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.OD =
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.DD =
20
AIR HANDLER DOES NOT include ducting)
Equal to or less than 10,000 CFM
X
$12.00 =
21
AIR HANDLER (DOES NOT include ducfin
Greater than 10,000 CFM
X
$15.OD -
22
EVAPORATIVE COOLERS
X
$10.00 =
23
TYPE I HOOD
X
$50.00 =
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
$20.00 =
27
AIR CONDITIONER
15-30 TON
X
$25.00 =
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
$10.00 =
32
WOOD STOVE - FREE STANDING
X
$25.00 -
33
REPAIR & ADDITIONS
X
$15.00 =
34
VENTILATION SYSTEMS
X
$12.00 =
35
VENTILATION MECHANICAL EXHAUST
X
$12.00 =
36
INCINERATOR - RESIDENCE
X
$19.00 =
37
INCINERATOR - COMMERCIAL
X
$22.00 =
METHOD OF PAYMENT:
❑ CASH ❑ CHECK ❑ VISA ❑ MC
CARD #
DATE:
EXPIRES:
SUBTOTAL
PROCESSING FEE $35.00
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE: