2005, 02-28 Permit App: 05000579 Mechanical FixturesProject Address:
Owner:
Mailing Address:
MECHANICAL PERMIT APPWCATION
Phone: (509) 688-0036; FAX: (509) 688-0037
For Inspections, Call (509) 688-0054
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Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Permit Use:
Phone (Daytime Contact): - 12 -
State
Contractor: License #: Phone #:
Mailing Address: / UJ -:5 F_ -'?
rm. - State lin r -t.
METHOD OF PAYMENT: SUBTOTAL
❑ CASH ❑ CHECK ❑ VISA ❑ MC DATE: PROCESSING FEE
CARD #: EXPIRES: TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
35.00
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 SEC min. AFUE rating)
Equal to or less than 400,000
X
$50.00 =
6
USED APPLIANCE SEC min. AFUE rating)
More than 400,ODO
X
$100.00 =
7
1 BOILER/REFRIGERATION
1 - 100M BTU
X
$12.00 =
8
BOILERIREFRIGERATION
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 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
X
$1.00 -
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 3 ADDITIONS
X
$15.00 =
34
VENTILATION SYSTEMS
X
$12.00 =
35
VENTILATION MECHANICAL EXHAUST
X
$12.00 =
36 1
INCINERATOR - RESIDENCE ?X
$19.00 -
37 t
INCINERATOR - COMMERCIAL
X
522-00 =
METHOD OF PAYMENT: SUBTOTAL
❑ CASH ❑ CHECK ❑ VISA ❑ MC DATE: PROCESSING FEE
CARD #: EXPIRES: TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
35.00
PLUMBING PERMIT APPLICATION `
I' I
Sne Phone: (509) 688-0036; FAX: (509) 688-0037
%1ky For Inspections, Call (509) 688-0054
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Project Address:
Owner: £
Mailing Address: _
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Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Permit Use:
Phone (Daytime Contact):
Zip Code
Contractor: License #: Phone #:
Mailing Address: H UD,- F 2`tT"
City State Zip Code
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
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 ONSfTE BUILT
X
$6.00
=
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
X
$6.00
=
6
DISHWASHER
X
$6.00
=
7
CLOTHES WASHER
X
$6.00
=
B
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
=
12
ROOF DRAINS/OVERFLOW
DRAINS
X
$6.00
=
13
FOUNTAINS, DRINKING
X
$6.00
=
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
X
$6.00
=
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
$6.00
=
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER, HOSE BIB,
STEAMER
PROOFER, CARBONATOR, SWAMP COOLER
X
$6.00
=
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE,
AND R.P.B.P.D. FOR: VATS. TANKS, BOILERS
X
$6.00
=
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
$6.00
=
19
MEDICAL GAS r outlet
NITROUS, OXYGEN
X
$6.00
=
20
MISCELLANEOUS PLUMBING
FIXTURE
X
1 $6.00
=
21
PRIVATE SEWAGE DISPOSAUSYS
X
$20.00
=
22
INDUSTRIAL WASTE
INTERCEPTOR
X
$15.00
=
METHOD OF PAYMENT:
❑ CASH ❑ CHECK ❑ VISA ❑ MASTERCARD
nATF- EXPIRES:
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: