2004, 03-03 Permit App: BLD-04-03681 AC 03/03/2004 14:46 5094841505 RR HEATING PAGE 02
City of ,. ` PLUMBING MECHANICAL
SPOKANE VALLEY PERMIT APPLICATION & 4)\0)..z.
PERMIT # -
_
• •
Contractor Information Applicant Information. T'
7Li<v C• /I/te �Jat4an 011
Job Address Owner Name J
ilea 4'
Contractor's Names Owner's Address O /r
•
1019 F. • Ce.fi / .gyp A_L- w 9r r�
Contractor's address Civ
is _ 14:3.17 SYS----c•e `p Cade
City Zip Code Owner phone number
gyp- /VoS
Contractor Phone Number Tax Parcel Number(Assessors f*tmber)
• Contractor's registration card(or copy)must be presented at
time of submittal
•
•
Fixture Count/Schedule of Work
Mechanical Basic fee 535. Plumbing Basic fee 535.
Number - Furnace (up to 100,000 btu) S15.ea Number Toilets Urinals S 6.ea
- Gas Hot Water Heater S10.ea _-_ Tub&faucets 5 6.ea
•
Cook Top&other appliances $10.ea Shower beads S 6.ea
Clothes dryer $10.es Bathroom sinks S 6.ea
Conversion burner . £10. Kitchen sinks S 6.ea
Gas logs,gas fireplace Insert 510.ea '- Dishwashers S 6.ea
Wood stove system S25. N Hot water tank $10.ea
Appilanec vent repair-relocation S 7.50 ea. Lawn sprinkling system S25.
Laundry Washer/sink $10.ea _-- Private sewage system $20.
,. . A/C unit ((up so 3 tons) 512. - Vacuum type breaker(5)S25.
Unit Hester (up to 100,000 btu) S12.ea Drinking
Drinking fountains S 6.ea
Fireplace insert (wood-pellets) £10.ea Floor Drains S 6.ea
Evaporative coolers $12.ea Sump $6.ea
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Commercial Hood 512.ca Backflow preventar S 6.ea
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Exhaust vents $8,ea pipe drainage repair 5 6.to
Ducts system S12. Hose Bib S 6.ea
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Gas miring ( outlets) S 5.up to 4 outlets
(5 1.for every outlet after 4)
Total
Total
_ 47�
Fee Cost 5 S . ha'er Fee Cost S 3 Total S
I hereby authorise the City of Spokane Valley to charge the fee for this permit to my credit Ctrs: CCA) f,c,,)
Visa Mastercard No.
Print name of holder -,Signature--...= .
•
Signature of applicant :,ate
.4, __ - „-
HOMEOWNER INSTALLER ONLY .
I hereby certify that rare the owner of the property described in this application.I understand that
the work is subject to inspection and approval by the City of Spokane Valley,and that I may not allow any •
other person,including a licensed contractor,to do any work under this permit.
Signature of owner ,Dare
FOR OFFICE USE ONLY
•
Date received Circle one: Plumbing _Mechanical Both
Supplemental to Permit Number: - Date Permit Issued
Permit Number Fee collected S •
Issued By:. Date
s-vme-pl
MAR 03 2004 13:52 5094841505 PAGE.02