2013, 06-25 Permit App: BLD-2013-1215 Plumbing, Mechanical Fixtures � ick-ll
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Permit Center
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Spokane Valley,WA 992C6
(509)688-0036 FAX:(509)688 0037 -, , , 1,-'''',':,.''',..,t,,,,,'?',_f' ,z .m.
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Community Development www.spokanevalley.oecot a
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Mechanical Permit Application o Com a-c2ai %'; 2esidential
SITE ADDRESS X01 L( f- 31 Ln CSV P P : T C_NTr$
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Name: O i A/1&0,/1&0,A,44 K n C)C- Coils f. ________LL, .R .nom__ • - _ `b�� -
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Name: Phone: Fax:
Address: City State Zip
License No: City Business License No:
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Name: Phone:
DESCRIPTION OF WORK #OF UNITS X COST = TOTAL AMOUNT
1 FUEL BURNING APPLIANCE Equal to or less than 100,000 _ 1 X $12.00 = I Z- -
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 1 X $10.00• = 10
13 RANGE S X $10.00 =
14 DRYER
1 X $10.00 = 10
15 FUEL BURNING WATER HEATERI X . $10.00 = 1 U
•
16 MISC.FUEL BURNING APPLIANCE X $10.00 =
17 GAS PIPING(each outlet) 3 X $1.00 = 3
18 DUCT SYSTEMS 11I X $10.00 = i'C)
19 VENTILATING FANS X $10.00 = y0
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 1 X $50.00 =
24 TYPE II HOOD ( X $10.00 = I
25 HEAT PUMP/AIR CONDITIONER 0-3 TON , X $12.00 = ,
26 AIR CONDITIONER 3-15 TON F X $20.00 = 7.O
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&ADDITIONSX $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 (25
❑CASH 0 CHECK 0 VISA 0 MC DATE: PROCESSING FEE $35.00
EXPIRES:
CARD#: TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE: REVISED 8/26/05
Permit Center t ' '
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.Spokane'' i 1707 E Sprague Ave Suite 106 H ; , r"'rc r f`�ia P �- °
Spokane Valley,WA 99206 V' `'"' � m a e - i
40000 Valley (509)688-0036 FAX: 509)688- 37 ' i '' ` ,,ki l
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Community Development www.spokanevalley.ore.com 1 a ;
Plumbing Permit Application 1 o Commeria Eldential
SITE ADDRESS lO2/g 1 39 . Ln 1 CSV r EFigii i1 C ^ TER
Name: 0;A.rMI'sin./1 K l7 G/C (n n c 4-• " teas:_'• . ,../..,L 7 �__. .,.__Fa
Address: City
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Name: GO)d ceci.1 P 6r3ti.9 4J } G d�i i Phone: Fax:
Address: J City State Zip
No: City Business LicenseNo:
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Name: Phone:
DESCRIPTION OF WORK #OF UNITS X COST = TOTAL AMOUNT
1 TOILETS WATER CLOSET,BIDETS 3 X $6.00 = I I
2 URINALS
X $6.00 =
3 X $6.00 = t Y
3 TUBS — ,
4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT I X $6.00 = Co
LAVS/BASINS,BAR,FLOOR,KITCHEN,
5 SINKS LAUNDRY,UTILITY,JANITOR,PHOTO, /' X $6.00 = .-G
X-RAY,FOOD,PREP/CULINARY MEAT I" _
6 DISHWASHER X $6.00 = 6
7 CLOTHES WASHER I X $6.00 _ = C.
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 1 X $6.00 =
ROOF DRAINS/OVERFLOW X $6.00 =
12 DRAINS ,
13 FOUNTAINS,DRINKING X $6.00 =
WATER PIPING/DRAIN-IN WASTE, NSTALLATION,ALTERATION,REPAIR, X $6.00
14 VENT,PLUMBING,REVERSAL REVERSALS =
15 SEWAGE EJECTOR GRINDER,SUMP PUMP X $6.00 =
ICE AN/OR COFFEE MAKER,HOSE BIB,
f 3 16 WATER USING DEVICE STEAMER X $6.00 = ! 2
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 X $6.00 =
20 FIXTURE
21 PRIVATE SEWAGE DISPOSAUSYS X $20.00 =
INDUSTRIAL WASTE X $15.00 =
22 INTERCEPTOR
SUBTOTAL 10 Z
METHOD OF PAYMENT: PROCESSING FEE
❑ CASH 0 CHECK 0 VISA 0 MASTERCARD $35.00
DATE: EXPIRES: TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE: REVISED 8/26/05