2011, 09-02 Permit App: BLD-2012-0485 Mechanical, Plumbing Fixturescri t center
1 1707 F Sprague Ave, Suite 106
{{ Spokane Valley, WA 99206
Il }1 yY 8 ,
(509)688-0036 FAX. (509)688 0037
C ommunity Devclopmeni a spots: c� alley_ ni., corn
f‘iieii,ll,: 811I;i.je'ariJ Ii(�li`Io:: i� A'Tpir1C:atiOrit ❑ CC.nifliii'I,lClicil'.
SITE ADDRESS 1-11D6 C.. • L. nWX
Wit -
PERMI"Z' NUMBER:
PERMIT FEE:
Building owner
Name:
Address:zvG-
D- t1 lM_-E___Ii_,_ (c),„cj- Phone RI
t-( Z9_60±-1 Fax g n: Lf
�GAO State j J Zip ���
/it' VOL /- City
-
Contractor
Name:
c ra
cult %Cc+ih_ Phone: Fax:
Address:
- i • _ City State
License No: City Business License No:
Zip
Contact
Name: pa,,,A Phone: 'Z./ - 41/ a 41
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
I
X
$12.00
=
I 2--
2
FUEL BURNING APPLIANCE
More than 100,000
X
$15.00
=
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
$50.00
=
6
USED APPLIANCE (WSEC 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
$35.00
=
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
I
X
$10.00
=
/ 0
15
FUEL BURNING WATER HEATER
1
X
$10.00
=
/ 0
16
MISC. FUEL BURNING APPLIANCE
X
$10.00
=
17
GAS PIPING (each outlet)
"2.-
X
$1.00
=
2-
18
DUCT SYSTEMS
j
X
$10.00
=
I U
19
VENTILATING FANS
3
X
$10.00
=
30
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
$15.00
=
22
EVAPORATIVE COOLERS
X
$10.00
_
=
23
TYPE I HOOD
X
$50.00
=
24
TYPE II HOOD
i
X
$10.00
=
f
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:
DCASH D CHECK 0 VISA 0 MC
CARD #t:
SUBTOTAL
V LI
$35.00
DATE:
PROCESSING FEE
EXPIRES.
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
REVISED 8/26/05
Community Development www.spokanevalkLy.org.com
Vili lmiiItbllu.T+.g Per li I I ARiiD 11Ca11i lion
SETS ADDRESS 11 IOU E . 11_1/o X
OCII ('creel
1170'7 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAQ:: (509)688-0037
-zo/ .21013 ---
PERMIT NUMBER:
PERMIT FEE:
uo Bang owsner
Name: biLh'l�O1�() ie e3LE— 4_°t S Phone: 2,e1 --_Fax q2(u
Address: (C+,'Z N, I
t. ✓I kVA City 5 b Ka l2 State 1„iA- Zip i
Contractor
_�
Name: bp\a Sea J
Phone:
Address:
License No:
Contac'
Name: a(,t
City
City Business License No:
Phone: `L 6/9 Z q
Fax:
State
Zip
DESCRIPTION OF WORK
# OF UNITS
TOILETS
WATER CLOSET, BIDETS
2
3
4
URINALS
TUBS
SHOWERS (PER TRAP)
5
6
7
8
SINKS
DISHWASHER
CLOTHES WASHER
BATH, STALL, ON-SITE BUILT
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
COST
X $6.00
X $6.00
X $6.00
$6.00
GARBAGE DISPOSAL
9
WATER SOFTENER
10
ELECTRIC HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
11
12
FLOOR DRAINS
ROOF DRAINS/OVERFLOW
DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
13
14
FOUNTAINS, DRINKING
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
16
WATER USING DEVICE
17
CROSS CONNECTION DEVICE
ICE AN/OR COFFEE MAKER, HOSE BIB,
STEAMER
PROOFER, CARBONATOR, SWAMP COOLER
VACUUM BREAKER, CHECK VALVE,
AND R.P.B.P.D. FOR: VATS, TANKS, BOILERS
$6.00
$6.00
$6.00
$6.00
$6.00
$6.00
$6.00
$6.00
$6.00
$6.00
$6.00
$6.00
TOTAL AMOUNT
i2
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
19
20
MEDICAL GAS (per outlet)
MISCELLANEOUS PLUMBING
FIXTURE
NITROUS, OXYGEN
21
22
PRIVATE SEWAGE DISPOSAUSYS
INDUSTRIAL WASTE
INTERCEPTOR
METHOD OF PAYMENT:
0 CASH ❑ CHECK
DATE:
AUTHORIZED SIGNATURE:
❑ VISA 0 MASTERCARD
EXPIRES:
$6.00
$6.00
$6.00
$6.00
iZ
$20.00
X $15.00
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
REVISED 8/26/05