2004, 02-03 Permit App: BLD-04-03493 Plumbing FixturesCity Of PL U,( MING I ECHANICAL
SPOKANE VALLEY PENT APPLICATION &
Gas Sot Water Heater
PERNM #
Coutractor Information
Applicant Information
_ Cook Top A admr appliances
$10. en
J� ,�d�
Owner NQ»,�—
ontraetor's axles
Owner'sAlddress
Sathrootn sinks S 6. ea
Contractor's address
City Zip Code
thea sinks S 6. to
City Zip Code
Ownerphone number
_
Diskwataers S 6. ea
Contractor .phone Number
Tax Parcel Number (Anessors Nurteber)
_
C'ontractor's registration card (or copy) must be presented at
_
Z52T5,��2 ;7
time of submitwL
r
Fixture Count /Schedule of Work
■rr rr.
Mechanical Basic fee
$35. Plumbing Basic fee $35.
Nuraber Furnace (up to 100,000 btu)
$3.5. oa Number Toilets t iriaals S 6. ea
Gas Sot Water Heater
$10. ea
Tub & (sneers $ 6. ea
_ Cook Top A admr appliances
$10. en
_T
$bower heads S 6. a
_ Civtkee dryer
510. ea
Sathrootn sinks S 6. ea
Conversion baser
$10.
thea sinks S 6. to
_
_ Goa togs, gas fireplace insert
510. es
_
Diskwataers S 6. ea
_ Wood stove system
SZS.
_
Hot rater tank S10. ea
_ Appliance vent repair - relocation
5 7.50 ea
_
Lana sprinkling system $25.
Laurufry Washer f dnk
S 10. ea
_
Private sewage rptem S20.
A1C aatt ((up to 3 tons)
$12.
_
Y
Vacuum typo brealrar (5) M
Unit Heater (np to 100,000 btu)
$12. a
Drfakin fountains $ 6. ea
R
Flroidaee imtert (,wad - pellet.)
$10. e■
-7
Floor Drains S 6. ea
)Paporativccoolers
Sit, a
$amp 5 d. ea
Commercial Hood
$12. ea
_
Backflow preventor $ 6. ea
Exhaust Yeats
S a. ea
pipe -drainage repair S 6. ea
_
Ditch system
512..
Rost: Bib S 6. OR
_
Gan Piping (,-_ outlets)
S S. up to 4 outlets
($ L for every outlet after 4)
Total
Total _
�ry
Fee cost S
Fes Cost $
Total
1 bertby sethoriae the City of Spokane Valley to charge the fee for this permit to my credit mrd:
Visa Mastercard No. .___ _... _.__. .._-._.. Explmtloadate
Print nim of holder Siguture _
Sigus&re of oppactumt Date
HOMMO WNER INSTALLER ONLY
I hereW eakify that I out the owner of the property dm=W in this appUcatioa- I understand that
W wont it vwhb et to laspecdan and approval try the Chy of Spokone Valley, and that r orgy met allow any
other person, Utd"q a Wensert cattrador, to do any war* under thtt permit
Sizaaagrr fow"" - -- Dah
FOR OFFICE USE ONLY
Date neaeivtd Circle one:
SuMernestal to Permit Number:
Permit Number
Issued By: Date
S-Vme-pl
Plumbing Meckaaical Both
Date Pu7nit Issaed
Fee collected S