2007, 02-16 Permit App: 07000454 Plumbing, Mechanical Fixtures 1 • Permit Center
S o 11707 E Sprague Ave,Suite 106 (,i
Spokane Valley,WA 99206 PERMIT NUMBER: 7' (1,-5-d,
Y (509)688-0036 FAX:(509)688-0037
Community Development www.spokanevailev.or¢ PERMIT FEE:
Plumbing Permit Application ❑ Commercial 0 Residential _
SITE ADDRESS: /0 2 64 6- d 44 L.-x
Building Owner
Name: Phone: Fax:
Address: City: State: Zip:
Contractor ( 4..0:7'h;wt &"Ji .--
Name: Kure f .�m 6/N Phone: 96 `l .%'7 OS- Fax: f Z— 7rc '
Address: 2zL Sr ClLs ke GHcelc_ 4.61 City: Sod Pt...{• State: Zip: 9 rr 2.0 4,
License No: City Business Lic:
Contact
Name: Phone:
DESCRIPTION OF WORK #OF UNITS X COST = TOTAL AMOUNT
1 TOILETS WATER CLOSET,BIDETS 2- X $6.00 =
2 URINALS X $6.00 =
3 TUBS / X $6.00 = -
4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT I X $6.00 =
LAVSBASINS,BAR,FLOOR,KITCHEN,
5 SINKS LAUNDRY,UTILITY,JANITOR,PHOTO, t/ X $6.00 =
X-RAY,FOOD;PREP/CULINARY MEAT
6 DISHWASHER ( X $6.00 =
7 CLOTHES WASHER I 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 = —
AREA CASE,COIL TRENCH,
11 FLOOR DRAINS CONDENSATE ( X $6.00 =
12 ROOF DRAINS/OVERFLOW 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 I
VACUUM BREAKER,CHECK VALVE,
AND R.P.B.P.D.FOR: VATS,TANKS,
17 CROSS CONNECTION DEVICE 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 =
20 MISCELLANEOUS PLUMBING FIXTURE X $6.00 =
21 PRIVATE SEWAGE DISPOSAUSYS X $20.00 =
22 INDUSTRIAL WASTE INTERCEPTOR X $15.00 =
SUBTOTAL
METHOD OF PAYMENT:
PROCESSING FEE
['CASH 0 CHECK 0 VISA//�,MC EXPIRES: _ $35.00
Card# VIN: . _. ..- TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE: lir
—
REVISED 8/26/05
.`
_ Permit Center
Spoka`nee' 11707 E Sprague Ave,Suite 106 PERMIT NUMBER:
Valley Spokane Valley,WA 99206
(509)688-0036 FAX:(509)688-0037
Community Development wu'w.spokanevallev.ore PERMIT FEE:
Mechanical Permit Application ❑ Commercial ❑ Residential
SITE ADDRESS:
Building Owner
Name: Phone: Fax:
Address: City: State: Zip:
Contractor
Name: Phone: Fax:
Address: City: State: Zip:
License No: City Business Lic:
Contact
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 =
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 X $10.00 =
15 FUEL BURNING WATER HEATER / X $10.00 =
16 MISC.FUEL BURNING APPLIANCE X $10.00 =
17 GAS PIPING(each outlet) 4' X $1.00 =
18 DUCT SYSTEMS ( X $10.00 =
19 VENTILATING FANS 4 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 I 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
E\PIRES:
['CASH 0 CHECK 0 VISA rMC PROCESSING FEE $35.00
f VIN•
CARD#: ,A, '_ TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE.
REVISED 8/26/05