2005, 05-04 Permit App: 05001443 Mechanical,Plumbing Fixtures MECHANICAL PERMIT APPLICATION Community Development Department
•
s okand . Building Division
s•O ' Phone: (509) 688-0036; FAX: (509) 688-0037 11707 E. Sprague Avenue, Suite 106
Yd1R� For Inspections, Call (509) 688-0054 Spokane Valley, WA 99206
Project Ad ess: / Si.? .5' e>e,E=04 .t1 ' i Permit Use: / ASzsu rei . l4r.
Owner: e7,,,r /1 ,...p.4 -1' .3.7r ,, 4 Phone (Daytime Confact):(j/263 -vso/
Mailing Address: /y 753 inisieovw j�0.. 1.// 49,E F"a// ,--19.s-,
City / State Zip Code
Contractor: /,‘-- License#: Phone#:
Mailing Address:
City State Zip Code
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 400,000 X $50.00 =
4 UNLISTED APPLIANCE(Additional Fee) More than 400,000 _ X $100.00 =
5 USED APPLIANCE(MEC 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 ' 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 3 X $10.00 =
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 $20.00 .=
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 STOVEJINSERTX $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: SUBTOTAL
0 CASH 0 CHECK 0 VISA 0 MC DATE: PROCESSING FEE $ 0
CARD#: EXPIRES: TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
PLUMBING PERMIT APPLICATION Community Development Department
Dr!! oll'il:\IN Building Division
ne Phone: (509) 688-0036; FAX: (509) 688-0037 11707 E. Sprague Avenue, Suite 106
Valley For Inspections, Call (509) 688-0054 Spokane Valley, WA 99206
Project Address: $- /5/7 di9�.�ziv ,tfo,P Permit Use: /,.., 1. e/ii .
• Owner: 4s,, ;a4 ,,,t/•c.1 (1)—€En,,,/ef's Phone (Daytime Contact): L / 3.psor/
Mailing Address: /}/7/q 1 --, hii mesio v ,efv = i,',:e ly. I.i,; - 97R/6-/FS T
City State Zip Code
Contractor: // License#: Phone#:
Mailing Address: •
City State Zip Code
DESCRIPTION OF WORK 0 OF UNITS X COST• = TOTAL AMOUNT
1 TOILETS WATER CLOSET,BIDETS 3-- X $6.00 =
2 URINALS X $6.00 =
3 TUBS / X $6.00 =
4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT / X $6.00 =
• LAVS/BASINS,BAR,FLOOR,KITCHEN,
5 SINKS LAUNDRY,UTILITY,JANITOR,PHOTO, X $6.00 =
X-RAY,FOOD,PREP/CULINARY MEAT 3
6 DISHWASHER / X $6.00 _ =
7 CLOTHES WASHER / X $6.00 =
8 GARBAGE DISPOSAL / X $6.00 = y
9 WATER SOFTENER X $6.00 =
10 ELECTRIC HOT WATER TANK • NOTE: IF GAS,SEE MECHANICAL / X $6 ..
FLOOR DRAINS AREA,CASE,COIL,TRENCH,CONDENSATE X $6.00 =
'ROOF DRAINS/OVERFLOW
12 DRAINS X $6.00 _ = •
13 FOUNTAINS,DRINKING X $6.00 =
WATER PIPING/DRAIN-IN WASTE, NSTALLATION,ALTERATION.REPAIR,
14 VENT,PLUMBING,REVERSAL REVERSALS X $6.00 =
15 SEWAGE EJECTOR GRINDER,SUMP PUMP X $6.00 =
ICE AN/OR COFFEE MAKER,HOSE BIB,
16 WATER USING DEVICE STEAMER <2 X $6.00 =
PROOFER,CARBONATOR,SWAMP COOLER
VACUUM BREAKER,CHECK VALVE,
17 CROSS CONNECTION DEVICE AND R.P.B.P.D. FOR: VATS,TANKS,BOILERS X $6.00 =
GREASE TRAP,SAND TRAP,
18 INTERCEPTORS CHEMICAL HOLDING TANK _ X $6.00 =
19 MEDICAL GAS(per outlet) NITROUS,OXYGEN X $6.00 = •
MISCELLANEOUS PLUMBING
20 FIXTURE X $6.00 =
21 PRIVATE SEWAGE DISPOSAL/SYS X $20.00 =
INDUSTRIAL WASTE
22 INTERCEPTOR X $15.00 = _
SUBTOTAL
METHOD OF PAYMENT:
PROCESSING FEE
0 CASH 0 CHECK 0 VISA 0 MASTERCARD .53 0
DATE: EXPIRES: TOTAL PERMIT FEE DUE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: •