2012, 06-08 Permit App: BLD-2012-0821 Plumbing, Mechanical Fixtures Permit Center 4 U' r - , 7i
SpO1�aI1e 11707 E Sprague Ave,Suite 106 � �a� E : P„ a
Spokane Valley,WA 99206 . _
•0010015'Valley (509)688-0036 FAX:(509)688-0037 +' -. ' ' ,, },
Community Development w•w•w•,spokanevallev.ors.com ILU ��= z
Mechanical Permit Applica iron o Commercial _Residential
SITE ADDRESS P7O/Zf i Z1/4 Ug-
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Name: t)j A .►kerma . C �c -, Phone: QV/ - �
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Address: 2(0o 2 N L.- City State , j Zip
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,-,.t.„Name: Sp0}Ct rke'_ ! [e VtGtin k Ca i Phone: :.'...7&--- 500 7 Fax
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Address: 1 _ was City State Zip
License No: SPO L'A/11 $8 7 City Business License No:
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Name: 111%.w\ Phone: -Li -Li 9? 4
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 Z ✓ _
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 =
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12 GAS LOG,GAS INSERT,GAS FIREPLACE X $10.00' = 10
13 RANGE I X $10.00 = (0
14 DRYER I X $10.00 = E 0
15 FUEL BURNING WATER HEATER ' X $10.00 = to ✓
16 MISC.FUEL BURNING APPLIANCE X $10.00 =
17 GAS PIPING(each outlet) 7.. X $1.00 = (-0 %
,Z ✓
18 DUCT SYSTEMS
1 X $10.00 = 10 ✓
19 VENTILATING FANS 3 X $10.00 = '3 0 v-
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 = !0 v
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: SUBTOTAL 1014
['CASH ❑CHECK ❑VISA 0 MC DATE: PROCESSING FEE $35.00
CARD#: EXPIRES: TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE: REVISED 8/26/05
Permit Center /2'08Z-
St O1 e 11707 E Sprague Ave,Suite 106 � p
p Spokane Valley,WA 99206
40000
Valley (509)688-0036 FAX:(509)688-0037
Community Development www.spokanevalley.ore.comrt
Plumbing Permit Application o Commercial Residential
SITE ADDRESS MI 12 e_ 41-E--2
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Name: bi tivte>Noo 1�G0,/Y /. Phone: 9 7 4—get CI Fax
Address: City State Zip
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Name: C90(r) SeEX I Phone: Fax:
Address: City State Zip
License No: City Business License No:
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Name: Pau l Phone: 2 i t-y 9 Z
DESCRIPTION OF WORK #OF UNITS X COST = TOTAL AMOUNT
1 TOILETS WATER CLOSET,BIDETS 3 X $6.00 = lc(
2 URINALS X $6.00 =
3 TUBS _ Z X $6.00 = 1 Z
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 = 3 G
X-RAY,FOOD,PREP/CULINARY MEAT (p
6 DISHWASHER ( X $6.00 = �p
7 CLOTHES WASHER ' 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 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 - 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 DISPOSAUSYS X $20.00 =
INDUSTRIAL WASTE
22 INTERCEPTOR X $15.00 =
SUBTOTAL
METHOD OF PAYMENT:
PROCESSING FEE
❑ CASH 0 CHECK 0 VISA 0 MASTERCARD $35.00
DATE: EXPIRES: TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE: REVISED 8/26/05