2005, 09-15 Permit App: 05003408 Plumbing FixturesPLUMBING PERMIT APPLICATION
Phone: (509) 688-0036;•FAX: 1509) 688-0037
;Owky. For Inspections, Call (509) 688-0054
Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
it
Project Address: RZI Ztnkk so v,. Permit Use:
Owner. _tel y4k llJ Phone (Daytime Contact): 5'31-901q
Mailing Address: cl ZL >y �i v cp_ _'::D6 ant.. 9 Lo 6
City State Zip Code
Contractor. License#: #oLL --j7okE Phone#: 7-16-8'�40
Mailing Address: _`3 Sq 6 Dtskwgh l� )) 5 9 Z ( 7
City State Zip Code
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
# OF UNITS
X
COST
-
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
$6.00
-
two
2
URINALS
X
$6.00
-
3
TUBS
X
$6.OD
-
6 CIO
4
SHOWERS PER TRAP
BATH STALL,ONSITE BUILT
Z.
X
$6.00
5
SINKS
LAVS/BASINS, BAR, FLOOR, KrrCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY FOOD, PREP/CULINARY MEAT
/I
X
$6.OD
=
2-e 00
1
6
DISHWASHER
X
$6.00
.00
00
CLOTHES WASHER
X
$6.00
B
GARBAGE DISPOSAL
X
$6.00
-
9
WATER SOFTENER
X
$6.00
-
10
ELECTRIC HOT WATER TANK
NOTE: 1F GAS, SEE MECHANICAL
X
$6.OD
-
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
X
$6.00
-
00
12
ROOF DRAINS/OVERFLOW
DRAINS
X
$6.00
-
13
FOUNTAINS, DRINKING
X
$6.OD
-
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING REVERSAL
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
X
$6.00
-
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
$6. D0
-
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER, HOSE BIB,
STEAMER
PROOFER, CARBONATOR, SWAMP COOLER
/
/
X
$6.00
=
C
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE,
AND R.P.B.P.D. FOR: VATS, TANKS, BOILERS
X
$6.00
-
16
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
$6.00
-
19
MEDICAL GAS r outlet)
NITROUS, OXYGEN
X
$6.00
-
20
MISCELLANEOUS PLUMBING
FIXTURE
X
$6.00
-
21
PRNATE SEWAGE DISPOSAUSYS
X
$20.00
-
ZL 1
INDUSTRIAL WASTE
INTERCEPTOR
X
$15.00
-
METHOD OF PAYMENT:
❑ CASH ❑ CHECKPROCESSING
❑ VISA ❑ MASTERCARD
DATE -EXPIRES:
SUBTOTAL
p-19 0 0
FEE
$35.00
TOTAL PERMIT FEE DUE:
117,
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
MECHANICAL PERMIT APPLICATION
wbbe Phone: (509) 688-0036; FAX: (509) 688-0037
For Inspections, Call (509) 688-0054
Project Address:
Owner.
Mailing Address:
Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Permit Use:
Phone (Daytime Contact):
City State Zip Code
Contractor. License #:
Mailing Address:
Phone #:
State
AUTHORIZED 51GNA1 URE:
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
$15.00 -
3
UNLISTED APPLIANCE Additional Fee
Equal to or less than 4DO,00D
X
$50.00 -
4
1 UNLISTED APPLIANCE Additional Fee
More than 400,000
X
$100.00 -
5
USED APPLIANCE SEC min. AFUE rating)
Equal to or less than 400,000
X
$50.00 -
6
USED APPLIANCE SEC min. AFUE rafin
More than 400,000
X
$100.00 -
7
BOILER/REFRIGERATION
1 - 100M BTU
X
$12.00 -
8
BOILERIREFRIGERATION
101 - 500M BTU
X
$20.00 =
9
BOILER/REFRIGERATION
501 -1,000M BTU
X
$25.00 -
10
BOILERIREFRIGERATION
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
1 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.D0 =
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
X
$10.00 -
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
X
$12.00 -
26
AIR CONDITIONER
3-15 TON
X
$20.OD -
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.D0 -
30
LPG STORAGE TANK
X
$10.00 =
31
WOOD OR PELLET STOVEIINSERT
X
$10. DO -
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 51GNA1 URE: