2005, 01-28 Permit App: 05000265 Furnace, Piping s - `- ,;5—... �(c�`7
/'` MECHANICAL PERMIT APPLICATION Community Development Department
wn \ Building Division
'7�111N�LG L Phone: (509) 688-0036; FAX: (509) 688-0037 11707 E. Sprague Avenue, Suite 106
dio Vdl For Inspections, Call (509) 688-0054 Spokane Valley, WA 99206
0 'v Permit Use: , dial U, e
Project Ad ss: . a„,
Owner fe Phone (Daytime onta ):
Mailing Address:
C 4 State Zip Code
Contractor: Cs0 )Q ( License#: Phone#:
Mailing Address:
City Stale Zip Code
DESCRIPTION OF WORK ft OF UNITS X COST = TOTAL AMOUNT, °-
1 FUEL BURNING APPLIANCE Equal to or less than 100,000 X $12 00 = /2.V�
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 HEATERX $10.00 =
16 MISC FUEL BURNING APPLIANCE X $10 00 =
17 GAS PIPING(each outlet) I X . $1.00 = t OD
18 DUCT SYSTEMS X $10 00 = ,
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 $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 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 =
3.4 VENTILATION SYSTEMS X $12.00 =
35 VENTILATION MECHANICAL EXHAUST X $12.00 =
36 INCINERATOR-RESIDENCEX $19.00 =
37 INCINERATOR-COMMERCIAL X $22.00 =
METHOD OF PAYMENT: SUBTOTAL Z-sCEI
❑CASH 0 CHECK 0 VISA 0 MC DATE- PROCESSING FEE $35.00
CARD ftEXPIRES: TOTAL PERMIT FEE DUE: I
AUTHORIZED SIGNATURE.
PLUMBING PERMIT APPLICATION Community Development Department
nOdie\a‘ Building Division
Phone: (509) 688-0036; FAX: (509) 688-0037 11707 E. Sprague Avenue, Suite 106
Val For Inspections, Call (509) 688-0054 Spokane Valley, WA 99206
de/
Project Address. Permit Use:
Owner: Phone (Daytime Contact):
Mailing Address:
City State Zip Code
Contractor: License #: Phone#:
Mailing Address:
City State Zip Code
DESCRIPTION OF WORK #OF UNITS X COST = TOTAL AMOUNT
1 TOILETS WATER CLOSET,BIDETS X $6 00 =
2 URINALS X $6 00
3 TUBS X $6 00 =
4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT X $6 00
LAYS/BASINS.BAR,FLOOR,KITCHEN,
5 SINKS LAUNDRY,UTILITY,JANITOR,PHOTO, X $6 00 =
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,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 DISPOSAL/SYS X $20 00 =
INDUSTRIAL WASTE
22 INTERCEPTOR X_ $15 00 =
SUBTOTAL
METHOD OF PAYMENT:
! PROCESSING FEE
0 CASH 0 CHECK VISA 0 MISTERCARD $35.00
DATE. EXPIRES: TOTAL PERMIT FEE DUE:
0
BANKCARD NUMBER. I �P�
AUTHORIZED SIGNATURE:
This document originally contained
confidential credit card information which
was redacted pursuant to RCW 19.255.010
and the original document destroyed
pursuant to SOS DAN GS2014-030.