2004, 09-28 Permit App: BLD-04-07783 Piping ti
PLUMBING PERMIT APPLICATION
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°Fk�Q City of Spokane Valley Community Development Department
Q BuifdngDivision
11707 E.Sprague Avenue, Suite 106
doe��le
Spokane Valley, WA 99206
Pyne: (509)688-0036;Fax: (509)688-0037
FOR INSPECTIONS, CALL(509)688-0054
Project Address: 6- 20 E y1 Permit Use:
Owner: Fe Woi..i Phone (Daytime Contact): 3o 23CYf
Mailing Address:
/ City State Zip Code
Contractor: An �7Q �'�'�2 ` ,.:cs ( License#: AIecocN\ 7LI{Phone#: 44S9-5-2
Mailing Address: 37/U "$ 2l7
City State Zip Code
*OF. TOTAL —
DESCRIPTION OF WORK UNITS X COST - AMOUNT
1 TOILETS WATER CLOSET,BIDETS X $6.00 =
2 URINALS X $6.00 =-
3
3 TUBS X $6.00 . = l
4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT X $6.00 =
' 5 SINKS LAVSIBASINS,BAR;FLOOR
KITCHEN,LAUNDRY,UTILITY, X $6.00 =
JANITOR,PHOTO,X-RAY,FOOD,
PREP/CULINARY/MEAT
6 DISHWASHER X $6.00 =
7 CLOTHES WASHER X $6.00 =
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,. X $6.00 =
CONDENSATE
12 ROOF DRAINS/OVERFLOW DRAINS X $6.00 =
13 FOUNTAINS,DRINKING X $6.00 =
14 WATER PIPING/DRAIN-IN WASTE, INSTALLATION,ALTERATION, X $6.00 =
VENT, PLUMBING,REVERSAL REPAIR,REVERSALS
15 SEWAGE EJECTOR GRINDER,SUMP PUMP X $6.00 =
16 WATER USING DEVICE ICE AN/OR COFFEE MAKER,
HOSE BIB,STEAMER,PROOFER, X $6.00 =
CARBONATOR,SWAMP COOLER
17 CROSS CONNECTION DEVICE VACUUM BREAKER.CHECK • ' •
VALVE,ANDRP.B.P.D.FOR: X $6.00 =
VATS,TANKS,BOILERS
18 INTERCEPTORS GREASE TRAP,SAND TRAP, X $6.00 =
CHEMICAL HOLDING TANK
19 MEDICAL GAS per outlet) NITROUS,OXYGEN X $6.00 =
20 MISCELLANEOUS PLUMBING FIXTURE X $6.00 = •
METHOD OF PAYMENT: SUBTOTAL
❑ CASH LI CHECK D VISA ❑ MASTERCARD PROCESSING fEE $35.00
DATE: EXPIRES: TOTAL PERMIT FEE DUE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
,-
• MECHANICAL PERMIT APPLICATION
� City of Spokane Valley Corn`munity Development Department
e BuiktingDivision
�leY 11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509)688-0036;Fax: (509) 688-0037
FOR INSPECTIONS,.CALL.(509) 688-0054
Project Address: Permit Use:
. Owner.. Phone(Daytime Contact):
• Mailing Address:
Contractor City State . Zip Code
License#: Phone#:
Mailing Address: .
City State Zip Code
#OF TOTAL
DESCRIPTION OF WORK - UNITS X COST • - AMOUNT
1 FUEL BURNING APPLIANCE Equal to or less than 100,000 X $15.00 =
---- -eE-lfUK APPLIA•
3 UNLISTED APPLIANCE(Additliona(Fee) Equal to or Less than 400,000 X $50.00 =
4 UNLISTED APPLIANCE(Additional Fee) More than 400,000 X $100.00 I _
USED APPLIANCE(WSEC min.AFUE
5 rating] Equal to or less than 400,000 X $50.00 =
USED APPLIANCE(WSEC mitt.AFUE
6 rating) More than 400,000 X $100.00 =
7 BOILER/REFRIGERATION 1-100M BTU • X $15.00 -
8 BOILER/REFRIGERATION 101-500M BTU X $28.00
9 BOILER/REFRIGERATION 501-1,000M BTU X $39.00 =
10 BOILER/REFRIGERATION 1,001-1,750M BTU X $57.00 I =
11 BOILER/REFRIGERATION More than 1,750M BTU - X $95.00 = •
't2 GAS LOG,GAS INSERT,GAS FIREPLACE • X $10.00 =
13 RANGE X $10.00 =
14 DRYER X $t0.00 - . _
15 FUEL BURNING WATER HEATER X $10.00 =
16 MISC.FUEL BURNING APPLIANCE X $10.00 = ,
17 GAS PIPING(each outlet) I X $1.00 = 4 S`-' 1 CO
18 DUCT SYSTEMS X $10.('0 =
19 VENTILATING FANS• 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 $19.00 =
22 EVAPORATIVE COOLERS X $10.00 =
23 TYPE t HOOD X $50.00 =
24 TYPE II HOOD X $10.00 =
25 ItEAT PUMP/AER CONDITIONER • , b-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 a 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 • WOODSTOVE-FREE STANDING X $25.00 --,-
METHOD
METHOD OF PAYMENT: SUBTOTAL _ 5 ,•CO
0 CASH 0 CHECK 0 VISA ❑MC DATE: PROCESSING FEE $35.00 !�-
CAS#; EXPIRES: TOTAL PERMIT FEE DUE: (..., 3 • . )
•
AUTHORIZED SIGNATURE: