2005, 04-25 Permit App 05001318 Plumbing FixturesPLUMBING PERMIT APPLICATION
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Phone:(509)688-0036;FAX: (509) 688-0037
�Wky For Inspections, Call (509) 688-0054
Project Address j Z `7 Q 3 E 0 [5M 67 A VC -
Owner VA N I V L
Mailing Address 12-503 i= VC31vIC7 Avg 5/
Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
5evvt7z h L v I, -f
PermitUse: I R z Ci € GrT LJrTy R"ilOm
Phone (Daytime Contact): 5b — x 5 2-- 3. N Y t
Contractor: 61v'(VM License #:
•-vi- 6°4't'LL-f t•VA
State
92_16
Zip Code
Phone #:
Mailing Address:
City State Zip Code
BANKCARD N
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
0 OF UNITS
X
COST
TOTAL AMOUNT
1
TOILETS
WATER CLOSET BIDETS
X
$6.00
-
2
URINALS
X
$5.00
-
3
TUBS
X
$6.00
-
4
SHOWERS PER TRAP
BATH STA ONSITE BUILT
X
$6.00
-
5
SINKS
LAVSBASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD PREPICULINARY MEAT
9
L`
X
$6.00
6
DISHWASHER
X
1 $6.00
1-
7
CLOTHES WASHER
i
X
$6.DD
=
6 •0-0
e
GARBAGE DISPOSAL
X
$6.00
=
9
WATER SOFTENER
X
$6.00
-
10
ELECTRIC HOT WATER TANK
NOTE IF GAS, SEE MECHANICAL
X
$6A0
-
11
FLOOR DRAINS
AREA, CASE COIL. TRENCH, CONDENSATE
X
$6.00
-
12
ROOF DRAINSIOVERFLOW
DRAINS
X
$6.00
-
13
FOUNTAINS, DRINKING
X
$6.DD
-
14
WATER PIPING/DRAIN-IN WASTE.
VENT, PLUMBING REVERSAL
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
X
$6.00
-
e v
O-
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
$6.00
-
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER, HOSE BIB,
STEAMER
PROOFER, CARBONATOR SWAMP COOLER
X
$6.00
=
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE,
AND R.P.B.P.D. FOR: VATS, TANKS BOILERS
X
$6.00
-
16
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X 1
$6.00
-
19
MEDICAL GAS rootlet
NITROUS OXYGEN
X
$6.00
-
20
MISCELLANEOUS PLUMBING
FIXTURE
X
$6.00
-
21
PRIVATE SEWAGE DISPOSALISYS
X
$20.00
-
22
INDUSTRIAL WASTE
INTERCEPTOR
X
$15.00
-
METHOD OF PAYMENT:
[I CASH b CHECK ❑VISA [3 MASTERCARD
MASTERCARD
u
DATE: / 2 5 4':5 EXPIRES:
SUBTOTAL
2 1 _ uT1
FEE
$35.00
TOTAL PERMIT FEE DUE:
S1' C -v
BANKCARD N
AUTHORIZED SIGNATURE:
Project Address:
Owner.
Mailing Address:
Contractor. License #:
Mailing Address:
Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Permit Use:
Phone (Daytime Contact):
Phone #:
MECHANICAL PERMIT APPLICATION
# OF UNITS X
T
Phone: (509) 688-0036; FAX: (509) 688-0037
For Inspections, Call (509) 688-0054
Project Address:
Owner.
Mailing Address:
Contractor. License #:
Mailing Address:
Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Permit Use:
Phone (Daytime Contact):
Phone #:
AUTHORIZED SIGNATURE:
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
$5D.00
-
4
UNLISTED APPLIANCE Additional Fee
More than 400,000
X
$100.00
=
5
USED APPLIANCE SEC min. AFUE ratio
E ual to or less than 400,000
X
$50.00
6
USED APPLIANCE SEC min. AFUE ratio
More than 400,ODO
X I
$100.00
=
7
BOILERIREFRIGERATION
1 -100M BTU
X
$12.00
=
8
BOILER/REFRIGERATION
101 -500M BTU
X
$20.00
=
9
BOILER/REFRIGERATION
501 -1 ODOM BTU
X
$25.00
=
10
SOILERIREFRIGERATION
1,001 -1 750M BTU
X
$35.D0
=
11
BOILERIREFRIGERATION
More than 1,750M BTU
X
$60.00
=
12
GAS LOG, GAS INSERT GAS FIREPLACE
X
$10.00
13
RANGE
X 1
$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
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
=
21
AIR HANDLER DOES NOT indude dueling)
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
=
28
AIR CONDITIONER
3-15 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
$60.150
=
30
LPG STORAGE TANK
X
$10.DD
31
WOOD OR PELLET STOVEANSERT
X
$10.DD
=
32
WOOD STOVE - FREESTANDING
X
$25.00
=
33
REPAIR & 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:
0 CASH 0 CHECK 0 VISA 0 MC
CARD #'
DATE:
EXPIRES:
SUBTOTAL
PROCESSING FEE
TOTAL PERMIT FEE DUE:
Ir. al,
AUTHORIZED SIGNATURE: