2003, 08-22 Permit App: BLD-03-02301 Plumbing ReversalIETHOD 0
3 CASH
oATE:
4F
Plumbing Permit Application
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane Va118`y, WA -99206 509-688-0037- Pax
For Inspections, call 509-688-0054
PROJECT /
ADDRESS I 'ov FC/77.2A1
(
PERMIT
USE:
DETAILS
OWNER 5frit S/ Ith Mr,
PHONE (Daytime Contact):
COST
MAILING ADDRESS:
/1,04,, 5'i'7 eh SA4,4 -tier 955/g76
AMOUNT
(street) (city/state) (Z72)
TOILETS
CONTRACTOR
tfi�hit,f,A t-,
ICESa:/TGh�
XY!/fu
Bzco
MAILING ADDRESS:
Roti PI /i // al &i
PHONE A:
2-- 5-/- o5
C-> r Z
[
URINALS
(street) / (city/state) (21?)
PLUMBING FIXTURES
ANKCARD NUMBER:
UTHORIZED SIGNATURE:
DESCRIPTION
DETAILS
# OF [INKS
X
COST
EQUALS
AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
$$
-
2
URINALS
X
$6
-
3
TUBS
X
56
4
SHOWERS (PER TRAP)
BATH, STALL, ONSITE BUILT
X
E6
5
SINKS
IAVS/BASINS, BAR FLOOR KITCHEN,
LAUNDRY, UTILITY, JANITOR PHOTO, X-
RAY, FOOD, PREP/CULINARY/MEAT
X
$6
-
6
DISHWASHER
X
-
7
CLOTHES WASHER
X
$6
8
GARBAGE DISPOSAL
X
-
9
WATER SOFTENER
X
86
-
10
ELECT. HOT WATER TANK
NOTE: P GAS, SEE MECHANICAL
X
$6
..
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
X
$6
-
12
FOUNTAINS, DRINKING
X
$6
-
13
WATER PJPING/DRAIN-IN
WASTE, VENT, PLUMBING-
REVERSAL
INSTALLATION, ALTERATION, REPAIR,
REVERSALS
/
X
$6
-
14
SEWAGE EJECTOR
GRINDER SUMP PUMP
X
$6
-
15
WATER USING DEVICE
ICE AND/OR COFFEE MAKER, HOSE BB,
STEAMER, TROOPER CARBONATOR,
SWAMP COOLER
X
$b
-
16
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE, AND
APBP.D. FOR VATS, TANKS, BOILERS
X
-
17
SPRINKLER SYSTEM
X
535
-
18
INTERLhFIURS
GREASE TRAP, SAND TRAP, CHEMICAL
HOLDING TANK
X
-
19
MEDICAL GAS per outlet
NHROU6,OXYGEN
X
56
-
20
MISC PLUMBING FIXTURE
X
S6
-
PAYMENT
�d+
CHECK D D.
SUBTOTAL:
PLUS PROCESSING FEE:
$35.00
TOTAL PERMIT FEE DUE:
ANKCARD NUMBER:
UTHORIZED SIGNATURE:
s#
alley
Mechanical Permit Application
11707 Eat Spragye flys ue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206 509-688-0037 - Fax
For Inspections, call 509-688-0054
PROJECT
ADDRESS:
DESCRIPTION OF WORK
PERMIT
USE:
OWNER
X
PHONE (Daytime Contact):
MAILING ADDRESS:
AMOUNT
(street)
(dty/state) (ZIP)
CONTRACTOR:
LICENSE #:
MAILING ADDRESS:
-
PHONE 5:
3
FUEL BURNING APPLIANCE
(street)
(city/state) (ZIP)
METHOD OF PA
❑ CASH
0
DATE EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
SOF UNITS
X
COST
EQUALS
AMOUNT
1
FUEL BURNING APPLIANCE
•OR< 100,000
X
515
-
3
FUEL BURNING APPLIANCE
a 1C0))00
X
519
•
3
UNLISTED APPLIANCE (AODMONAL FEE)
• OR <400400
X
550
•
6
UNLISTED APPLIANCE (ADDIRONAL FEE)
>400,000
X
$100
-
5
USED APPLIANCE (WSEC min. AFUE rating)
• or c4000
X
$50
•
6
USED APPLIANCE (WSEC mIn AFUE rating)
a4Cg000
X
5100
•
7
BOILEWREFNGERADON
1-1WM BTU
X
515
•
5
BOILER/REFRIGERATION
101.500M BM
'X
528
•
9
BOILER/REFRIGERATION
501.1,0001d BIL
X
539
•
10
liOILENREFRIGERATION
1001.1,750M BTU
X
557
•
11
BOILER/REFRIGERATION
41750M BTU
X
595
•
12
GAS LOG, GAS INSERT, GAS FIREPLACE
-
X
510
-
U
RANGE
-
X
510
•
144
DRYER
_
X
510
-
15
FUEL BURNING WATER HEATER
-
X
510
-
16
MEC FUEL BURNING APPL
-
X
510
•
17
OAS PIPING (en Outlet)
-
X
51
-
18
DUCT SYSTEMS
-
' X
510
-
19
VENTLATING FANS
-
X
510
-
20
AIR HANDLER (DOES NOT include ducting)
• OR < 10,00001M
X
512
-
21
AI(HANDLER(DOES NOT Include ducting)
> 10.(o csi
X
519
-
22
EVAPORATIVE COOLERS
-
X
510
23
TITE 111000
-
X
550
-
24
TYPE Il HOOD
-
X
110•
25
HEATPUMPIA1R CONDITIONER
0-3TON
X
512
-
26
AIRCONDFOONER
5.15 TON
X
520
-
27
AIR CONDITIONER
15-30 TON
X
525
•
28
AIR CONDITIONER __
30:O TON
X
535
-
29
AIR CONDn10NER
+50 TON
X
500
-
30
LPG STORAGE TANK
-
X
510
•
31
WOOD ORPELLET STOVE/INSERT
-
X
510
3E
WOOD STOVE - FREE STANDING
-
X
525
-
DENT
• yp, `L!
SUBTOTAL
PLUS PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE
DATE EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: