2003, 03-31 Permit: BD03-004 Plumbing Fixtures ______
04_ '7 10
City of �d'i P UMBING/MECHANICAL
SPOKANE VALLEY .� PERMIT APPLICATION &
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, PERMIT # g6- d �- 00 � A
____ ===_Contractor Informatio ------- Applicant Inform do
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Job Address Owner Name
Ala-, L/..�1,' //e_25[ 7/AZ
Contractor's Names . Owner's Address
E /0...7c, 3 /r-/ Sj9.9A.- , /74./4c
Contractor's address City / Zip Code
90
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i7.,,1%_ a KiAs91,..1t0 -¢ 77 - �-f
C / Zip Code Owner phone number
�/6--.?X' 7/
Contractor Phone Number Tax Parcel Number(Assessors Number)
Contractor's registration card(or copy)must be presented at
time of submittal.
Fixture Count/Schedule of Work
Mechanical Basic fee $35. Plumbing Basic fee $35.
Number Furnace (up to 100,000 btu) $15.ea Number / Toilets Urinals $6.ea
Gas Hot Water Heater $10.ea Tub&faucets $6.ea
Cook Top&other appliances $10.ea _ Shower heads $6.ea
Clothes dryer $10.ea _ Bathroom sinks $6.ea
Conversion burner $10. / Kitchen sinks $6.ea
Gas logs,gas fireplace insert $10.ea _ Dishwashers $6.ea
Wood stove system $25. Hot water tank $10.ea
Appliance vent repair-relocation $7.50 ea _ Lawn sprinkling system $25.
Laundry Washer/sink $10.ea - Private sewage system $20.
A/C unit ((up to 3 tons) $12. Vacuum type breaker(5)$25.
-
Unit Heater (up to 100,000 btu) $12.ea Drinking fountains $6.ea
-
Fireplace insert (wood-pellets) $10.ea - Floor Drains $6.ea
Evaporative coolers $12.ea - Sump $6.ea
- Commercial Hood $12.ea Backflow preventor $6.ea
- Exhaust vents $8.ea - pipe-drainage repair $6.ea
Ducts system $12. _ Hose Bib $6.ea
- Gas Piping ( outlets) $5.up to 4 outlets
($1.for every outlet after 4)
Total _
Total _ 0 0
Fee Cost$ Fee Cost$ Total$ 5-.3
I hereby authorize the City of Spokane Valley to charge the fee for this permit to my credit card:
Visa Mastercard No. _ _ Expiration date
Print name of holder Signature
Signature of applica t /Date
HOMEOWNER INSTALLER ONLY
I hereby certify that I am 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 1 may not allow any
other person,including a licensed contractor,to do any work under this permit.
Signature of owner Date
FOR OFFICE USE ONLY
Date received 3= 3/-0 Circle one: bing ''' Mechanical Both
Supplemental to Permit Number: Date Permit Issued 3- 3/-c'
Permit Number
j /.:) -0; -d 0 '/ Fee collected$ SSS/
Issued By: j-7%iDate lU 3
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