2012, 05-03 Permit App: BLD-2012-0478 Plumbing, Mechanical Fixtures•
�, a Permit Center
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piokaEde 11707E Sprague Ave, Sung 106
.NTIT_NUMBER:
Community Development iywya ,pokanevallgy of con) "``PE12MitititE
Volley Spokane Valley, WA 99206
(509)688-0036 FAX. (509)658-0037
Plumbing Permit Application ❑ CornmeL-C43i ECResidenftiai
SITE ADDRESS 1001 S. /Via pug-- '2 .-
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DESCRIPTION OF WORK
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Name biQt 04.0(...dIW!
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Address: Z(od2 . S
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city JPv�lL Sta
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Name:Phone:
$6 00
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Fax.
3
TUBS
Address: 6., 7�
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$6.00
City State
Zip
4
License No:
BATH, STALL, ON-SITE BUILT
1
City Business License No:
$6.00
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#.e'er
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY. FOOD, PREP/CULINARY MEAT
1 (
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X
r=5- �'-'s�•—� $.- r 1
Y._
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Name: �iU
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DISHWASHER
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PhnnP '%(iP— %�
1
X
AUTHORIZED SIGNATURE:
.REVISED8126/05
DESCRIPTION OF WORK
I/ OF UNITS
X
COST
=
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
2
X
$6 00
=
1 Z-
2
URINALS
X
$6 00
=
3
TUBS
Z
X
$6.00
=
Z
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
1
X
$6.00
=
Co,
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY. FOOD, PREP/CULINARY MEAT
1 (
`�
X
$6 00
=
,Z , i
`�
6
DISHWASHER
1
X
$6.00
=
ie
7
CLOTHES WASHER
1
X
$6 00
=
id
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
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
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
I Z.
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
=
21
PRIVATE SEWAGE DISPOSAUSYS
X
$20.00
=
-
22
INDUSTRIAL WASTE
INTERCEPTOR
X
$15.00
=
METHOD OF PAYMENT:
❑ CASH 0 CHECK
DATE-
SUBTOTAL
-fl
❑ VISA ❑ MASTERCARD
PROCESSING FEE
$35.00
EXPIRES
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
.REVISED8126/05
S.,..
Valley
Community Development
Mechanical Penni
Pen nil Center
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX (509)658-0037
www.sookaneaallcy.oi e corn
Application
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Phone:
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Address: City State Zip
License No: City Business License No:
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Name:
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DESCRIPTION OF WORK
It OF UNITS
X
COST
=
TOTAL AMOUNT
1
FUEL BURNING APPLIANCE
Equal 10 or less than 100,000
i
X
$12.00
=
/ 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
=
I
15
FUEL BURNING WATER HEATER
I
X
$1000
=
I O
16
MISC. FUEL BURNING APPLIANCE
X
$10.00
=
17
GAS PIPING (each outlet)
'Z
X
$1 00
=
7-
18
DUCT SYSTEMS
I
X
$10.00
=
I U
19
VENTILATING FANS
3
X
$10.00
=
3()
20
AIR HANDLER (DOES NOT indude 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
850.00
=
24
TYPE II HOOD
I
X
$10.00
=
10
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
X
$12.00
=
26
AIR CONDITIONER
3-15 TON
X
$20.00
=
27
AIR CONDITIONER
1530 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
$1000
=
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 0 VISA 0 MC
CARD p
SUBTOTAL
T (-1 /
DATE:
PROCESSING FEE
$35.00
EXPIRES
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
REVISED 8/26/05