2008, 01-07 Permit App: 08000051 Plumbing, Mechanical Fixtures (2) ,,6/ ,_ Permit Center
s.*Wane 11703E Sprague Ave,Suite B-3
..O 1e PERMIT NUMBER:8- oQs-
�Valley Spokane Valley,WA 99206
(509)688-0036 FAX:(509)688-0037 2 c
Community Development www.spokanevalley.org PERMIT FEE: ei .) . J
Plumbing Permit Application n Commercial I I Residential
SITE ADDRESS: I 1 2 2-1 'E_• 31 S t '�v+'vc ut-
Building Owner ,
Name: j ,.. c t G_t..k u C Phone: /::,Lc-•'I? q_ C 2 o f Fax:
Address: S r City: State: Zi
11� E 3` *l vt��p c','t 1C.:,vv. Vc'1IleL Lt; Ap' C fl7ZC
Contractor
Name: Phone: Fax:
Address: City: State: Zip:
License No: City Business Lic:
Contact
Name: �s-u�(� �i:tlet.i ( Phone: ' z zq. G S'] —
� t
DESCRIPTION OF WORK #OF UNITS X COST = TOTAL AMOUNT
1 TOILETS WATER CLOSET,BIDETS i X $6.00 =
2 URINALS X $6.00 =
3 TUBS t X $6.00 =
4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT I 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 WATER HEATER NOTE: IF GAS,SEE MECHANICAL X $6.00 =
AREA,CASE,COIL,TRENCH,
11 FLOOR DRAINS CONDENSATE X $6.00 =
12 ROOF DRAINS/OVERFLOW 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,
AND R.P.B.P.D.FOR: VATS,TANKS,
17 CROSS CONNECTION DEVICE 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 =
20 MISCELLANEOUS PLUMBING FIXTURE X $6.00 =
21 PRIVATE SEWAGE DISPOSAUSYS X $20.00 =
22 INDUSTRIAL WASTE INTERCEPTOR X $15.00 =
SUBTOTAL
METHOD OF PAYMENT:
PROCESSING FEE
DCASH 0 CHECK 0 VISA 0 MC EXPIRES: $35.00
Card# VIN: TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
Effective October 28,2007
P:\Community Development\Forms\Building forms\Plumbing Permit Application.doc
Permit Center
S.n<. 11703E Sprague Ave,Suite B-3
pokane \ Spokane Valley,WA 99206 PERMIT NUMBER:
../Valley (509)688-0036 FAX:(509)688-0037
PERMIT FEE:
Community Development www.spokanevalley.org
Mechanical Permit Application Commercial X Residential
I
SITE ADDRESS: Z 1 I 2. ' >_ __7) � % CC t ( ui c
Building Owner
Name: iir c c.,_ 1,3 elc-1t vt5Phone: Scy l-el 22-1 _C 2. `-j Fax:
Address: 1 j - z 1 E , I s r A Jrr.v‘ c City:.. 1. k�i 1,a. V ct i 1 t.,i State: Zip: I i.Z t i.-
,
Contractor i.
Name: ..14,o,. ....„ Phone: Fax:
Address: City: State: Zip:
License No: City Business Lic:
Contact
Name: f),,. C� (--s,,.�.,,t5 IZ u.I<. lZ 1 z)nz v� Phone: S LI j j Z.`1 c (,:s`t,
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(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 HEATER X $10.00 =
16 MISC.FUEL BURNING APPLIANCE X $10.00 =
17 GAS PIPING(each outlet) X $1.00 =
18 DUCT SYSTEMS 4 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 =
J
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 4-15 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 8r ADDITIONS X $15.00 =
34 VENTILATION SYSTEMS X $12.00 =
35 VENTILATION MECHANICAL EXHAUST X $12.00 =
36 INCINERATOR-RESIDENCE X $19.00 =
37 INCINERATOR-COMMERCIAL X $22.00 =
METHOD OF PAYMENT: SUBTOTAL
DCASH D CHECK 0 VISA 0 MC EXPIRES. PROCESSING FEE $35.00
CARD#: VIN: TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
Effective 10-28-07 P:\Community Development\Forms\Building forms\Mechanical Permit Application.doc