2013, 06-28 Permit App: BLD-2013-1274 Mechanical, Plumbing FixturesSpokarrle
.0,001wValley
Community Development
Permit Center
11707 E Sprague Ave, uite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
www.spokanevallev.ore.com
Mechanical Permit Application
o Commercial AResidential
SITE ADDRESS 31.0q S. y G+^
t i diY k�4 �
-Buildibg:owner :�> ,_ ��,;..., ,�'.��:�,.._ .-P ... .�
tz r ��
� a ... ..�
�r.�,
�.
Name: pt04rNoytC,I 4L k Coy% S7
Phone:
9 Z'i -rf6 ef Fax
Address:
City State
Zip
�, of l .. $ :.,y Y+y }: F y� ti _ f� ..i N.• .. riq
Y�L Oti ^c+i,�'�. %a�isY<-,S d�l -3iY: i'r,.PAaG;Y>•�2'3i-S b..>..�..,�Y9s,.
:
ra
J V' � y * P
3; , r :-n Si;Fi5:. 'i
. 9Py
my
�+S'�'1�
L.7'a
Name: A. i i D S !, y1
Phone:
Fax:
Address:
City State
Zip
License No:
City Business License No:
O�O �yys*5M1s}�,`� '+i� .¢ 5 t .A.. `- "^s. e' r
xaY,Q,ff��.vd, i+,�'�}'?', t^.M .'l^'*4p.'�i�Y eo..�.�`.*:�.14"+`�`?
s. -S•
„.i ,.
t�4.. _-r..,``&A Kff '3.. ¢:„
V-..yF $�, ''t-Sa4.:.:-"m_
.r"
-r `pt..TfiS�
'7
Name:
Phone:
DESCRIPTION OF WORK
# OF UNITS
X
COST
= TOTAL AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
X
$12.00
'11
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 Tess 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
l0
13
RANGE
X
$10.00
14
DRYER
X
$10.00
�o
15
FUEL BURNING WATER HEATER
X
$10.00
10
16
MISC. FUEL BURNING APPLIANCE
X
$10.00
17
GAS PIPING (each outlet)
3
X
$1.00
3
18
DUCT SYSTEMS
X
$10.00
/0
19
VENTILATING FANS
L'1
X
$10.00
40
20
AIR HANDLER • OES NOT include ductin. )
Equal to or Tess 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
IU
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
X
$12.00
Z
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 0 CHECK 0 VISA ❑ MC
CARD #:
AUTHORIZED SIGNATURE:
DATE:
EXPIRES:
SUBTOTAL
617
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
REVISED 8/26/05
Permit Center
11707 E Sprague Ave, uite 106
p"okane Spokane Valley, WA 99206
Valley (509)688-0036 FAX: (509)688-0037
Community Development www•.spokanevallcy.ora.com
Plumbing Permit Application
o Commercial ist Residential
SITE ADDRESS 3 ou S. 4/16.--c i L ✓i
AUTHORIZED SIGNATURE:
REVISED 8/26/05
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
Name: 0 i c.. riA0Y1A 406 it rrMS
Phone: 9' 9 G q
Fax
Fax
WATER CLOSET, BIDETS
3
X
$6.00
Address:
City
State
URINALS
Zip
X
' YY %r3Y •,'�A '+" �^t '�'
s'Z-,,43, it'�,1OP Avg �� .i, . Ak 4 ;x.,. £ -��'. �,i _
,. FX.. _, Ir��.N':xS �'N a•..,!�n .e._ w x"
'3 � "'�Y-_ .ri+� F' �`"
+ X, �,.'p ,�c� tc_. .v, '?,mss -b A ..�.. "�' .R...d,.
-t L` .,I."!
k �"�f-�.&fryi F+_s`"i
.. t . ,� ';;"`.
3
TUBS
_ �
^ :.
's _
4,.. •- 'i
Name: (f) c•14 i rt/lee kun i ra 1 4'
P/U m bi Ll gPhone:
Fax:
11
4
SHOWERS (PER TRAP)
BATH, STALL, ONSITE BUILT
Address:
/ City
State
=
(o
Zip
SINKS
License No:
City Business License No:
X
$6.00
=
6
6
.... tt( ,.,T • ` ,. �'+', � g
1 y.4.1.,V4' , �� 'j �i
:.. .pxe � 1".," .
^`F .'eSxr+ 1 ".--7i.
•,,. 'R^1 �( �, '":1�`���� ��
� �.i� �k�"'kR .e4, r R2,
$3 :g q
'ky� `l
��. A�x` �'
�S
.»�J'
-R..
x� y gy.�i„
?if �. Y.., �
�. :d
a...-
Name: •
Phone:
1.
X
$6.00
=
AUTHORIZED SIGNATURE:
REVISED 8/26/05
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
3
X
$6.00
=
1 8
2
URINALS
X
$6.00
=
3
TUBS
3
X
$6.00
=
11
4
SHOWERS (PER TRAP)
BATH, STALL, ONSITE BUILT
1
X
$6.00
=
(o
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
%
SCJ
X
$6.00
=
6
6
DISHWASHER
1
X
$6.00
=
6
7
CLOTHES WASHER
1.
X
$6.00
=
6
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
1
X
$6.00
=
/
6
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
3
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
=
21
PRIVATE SEWAGE DISPOSAUSYS
X
$20.00
=
22
INDUSTRIAL WASTE
INTERCEPTOR
X
$15.00
=
METHOD OF PAYMENT:
0 CASH 0 CHECK
DATE:
SUBTOTAL
I) l
0 VISA 0 MASTERCARD
PROCESSING FEE
035.00
EXPIRES:
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
REVISED 8/26/05