2003, 07-01 Permit App: BLD-03-02016 Plumbing FixturesSarrl ' ` 11707 Past SprIIgue Avenue, Suite 106 509-688-0036 - Phone
pokane Spokane Valley, WA 99206 509 -688 -0037 -Fax
For Inspections, call 509-688-0054
Mechanical Permit Application (_,)-2
PROjEC7
1#OFNVTDS X
PERMIT
1 IFUEL BURNINGAPPLIANCE
ADDRESS: CMCJ �67
X
E
USE:
>IXAX
OWNER O —J
ZAJ_1
3 UNLLSTED APPLIANCE (ADOFnONAL FEE)
PHONE(Daytime Contact):
MAILING ADDRESS:
550
4 UNLLS[EOAPPLIANCE(ADD'O FEE)
>4W,W3
X
$1X
5 OSEO APPLIANCE(WSECmIrt A Enting)
5
X
(street)
6 USED APPLIANCE (N5EC mn. gFUE nting)
dty/state)
%
(ZIP)
CONTRACTOR: n , .,
t
c H /
LICENSE 1:
'W!__ G. L
MAILING ADDRESS:
101-SXMBTU
-X
PHONE I:
9 BOILER>REFRIGERATON
SJI-LX]M BN
X
339
10 BOhENREFRIGERATON
101 117WM0IV
X
eJ
11 BOILER/REFRIGER
11XM BTU
Er
11 GASLOG, GAS WSERI, CPS FIXEPWCE
X
f10
(street)
(d state)
S10
(ZIP)
METHOD OF PAY
DESCRIPTTONOFWORX
1#OFNVTDS X
COST EQUALS AMOUW
1 IFUEL BURNINGAPPLIANCE
•OR<IXpX
X
f15
1 FUEL BURIJING APPLIgNCE
>IXAX
X
319
3 UNLLSTED APPLIANCE (ADOFnONAL FEE)
•OR<4LV,M
X
550
4 UNLLS[EOAPPLIANCE(ADD'O FEE)
>4W,W3
X
$1X
5 OSEO APPLIANCE(WSECmIrt A Enting)
w<4X,X]
X
SX
6 USED APPLIANCE (N5EC mn. gFUE nting)
a4X,XJ
%
$1X
l BOILERBEFWGEMTON
LIXMBN
X
SII
g BOREM[EFRIGERATON
101-SXMBTU
-X
$a
9 BOILER>REFRIGERATON
SJI-LX]M BN
X
339
10 BOhENREFRIGERATON
101 117WM0IV
X
Ss7
11 BOILER/REFRIGER
11XM BTU
Er
11 GASLOG, GAS WSERI, CPS FIXEPWCE
X
f10
13 RANCE
X
S10
14 DRYER
X
Sl0
15 NEL BURNING WATER HEATER
16 ADSL FUEL BMMNG kRPL.
x
g10
17 GAS KPINGf O flet)
X
51
18 DUMS EMS
X
510
19 VENoLATWG FANS
X
f1B
X AL NOLER(DOESNOT mdudeduceng)
•Oa<jcL M
X
f17
31 Apt HANDLER (DOES NOT Ndude dusting)
>10MCFM
• EVAPORATVE COOLERS
X
510
• TTE IHOOD
x
ggg
H rTERHOOD
%
S10
25 HEATPUN�/MRCONDNONER
03TON
X
f13
M MRCONDMONER
315 TON
X
530
37 AIRCONDMONER
1S30TON
X
AS
2 MRCONDMONER
3 !o TON
%
535
M URCONDMONER
r50 TON
X
WI
W LPG5TORAGETANK
X
310
31 WOOD OR PELLET STOVERNSERT
X
$10
K WOOD STOVE - FREE SSANDMG
X
p5
4ENT
y�TOTAL
SUBTOTAL:
PLUS PROCESSING FEE: $35.00
PFRMST FEE DUE
❑ CASH ❑ CHE ❑
DATE:
BANKCARD NUMBER
AUTHORIZED SIGNATURE:
M
EXPIRES:
ETHOD OF
I CASH
Smx� Enke 11707 East Sprague Avenve, Suit,; 106 509-688-0036 - Phone
pokane I Spokane Valley, WA 99206 509 -688 -0037 -Fax
j` l J For Inspections, call 509-688-0054
Plumbing
gguaPermit Application
PROJECTPERMIT
ADDRESS:
USE:
OWNER:
PHONE (Daytime Contact):
MAILING ADDRESS:
(street) (dty/state) (ZIP)
CONTRACTOR
LICENSE M:
MAILING ADDRESS: PHONE #:
(street) (City/state) (ZIP)
PLUMBING FIXTURES
ATE'
4NKCARD NUMBER
)T IRDRIZED SIGNATURE:
EXPIRES:
IPTI
DESCRON
DETAILS
4 O UATIS
X COST
EQUALS
AM OUNT
1
ToRns
WATER CLOSET, BIDETS
X S6
2
URINALS
X E6
3
TUBS
X j6
4
SHOWERS(PERTRAP)
BATH,SrALL,ON-SITEBIIILT
X $6
5
SINKS
LAVS(BASINS, BAR FLOOR KRCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO, X-
RAY, FOOD, PREP/CULINARY/MEAT
X 56
-
6
DISHWASHER
X E6
7
CLOTHESWASHER
X M
8
GARBAGEDISPQRAL
X $6
9
WATER SOFTENER
X S6
10
ELECT. HOT WATERTANK
NOM ¢ GAS, SEE MECHANICAL
X $6
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH CONDENSATE
X $6
-
12
FOUWAINS, DRINKING
X $6
13
WATER PIPING/DRAIN-IN
WAS R VEIN, PLUMBING
REVERSAL
INSTALLATION, ALTERATION, REPAIR
REVERSALS
X E6
-
14
SEWAGE EJECTOR
GRINDERSUMPFUMP
X $6
15
WATER USING DEVICE
ICE AND/OR COFFEE MAKER HOSE BIB,
STEAMER PROOFER, CARBONATOR
SWAM? COOLER
X $6
-
16
CROE5 CONNECTION DEVICE
VACWM BREAKER CHECK VALVE, AND
RP BT D. FOR: VATS, TANKS, BOILERS
X
-
17
SPRINKLER SYSTEM
X §25
1B
IMERCEProm
GREASE TRAP, SAND TRAP, CHEMICAL
HOLDP G TANK
X
-
19
MEDICAL GAS peroudet
NITROUS, OXYGEN
X E6
20
MIBC. PLUMBING F)GEIRE
X f6
PAYMENT
r
SUBTOTAL:
PLUS PROCESSING FEE:
$35.00
TOTAL PERMFE FEE DUE:
•
I 1 l
ATE'
4NKCARD NUMBER
)T IRDRIZED SIGNATURE:
EXPIRES: