2004, 01-28 Permit App BLD-04-03472 Plumbing FixturesMETHOD 0
0 CASH
*Wane
si si e
..'Valley
Plumbing Permit Application
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206 509-688-0037 - Fax
For Inspections, call 509-688-0054
PROJECT
ADDRESS:
PERMIT
USE:
OWNER:
PHONE (Daytime Contact):
MAILING ADDRESS:
(street)
(city/state) (ZIP)
CONTRACTOR: �
�� ��
p
LICENSE #:
MAILING ADDRES :
PHONE #:
(street)
(city/state) (ZIP) •
PLUMBING FIXTURES
DESCRIPTION
DETAILS
# OF UNITS
X
COST
EQUALS
AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
/
X
$6
-
2
URINALS
X
$6
-
3
TUBS
X
$6
-
4
SHOWERS (PER TRAP)
BATH, STALL, ON -SITE BUILT
/
X
$6
-
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO, X-
RAY, FOOD, PREP/CULINARY/MEAT
/
X
$6
-
6
DISHWASHER
X
$6
-
7
CLOTHES WASHER
X
$6
-
8
GARBAGE DISPOSAL
X
$6
-
9
WATER SOFTENER
X
$6
-
10
ELECT. HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
$6
-
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
X
$6
-
12
FOUNTAINS, DRINKING
X
$6
-
13
WATER PIPING/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 BIB,
STEAMER, PROOFER, CARBONATOR,
SWAMP COOLER
X
$6
-
16
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE, AND
R.P.B.P.D. FOR: VATS, TANKS, BOILERS
X
17
SPRINKLER SYSTEM
X
$25
-
18
INTERCEPTORS
GREASE TRAP, SAND TRAP, CHEMICAL
HOLDING TANK
X
$6
-
19
MEDICAL GAS per outlet
NITROUS, OXYGEN
X
$6
-
20
MISC. PLUMBING FIXTURE
X
$6
-
PAYMENT
• VISA- iteas
] CHECK ❑ Ran= ■ `__. =_.`.
SUBTOTAL:
PLUS PROCESSING FEE:
$35.00
TOTAL PERMIT FEE DUE:
DATE: FJLPIRES:
BANKCARD NUMBER
AUTHORIZED SIGNATURE:
Spo�kan'' e\'`
419;oo Valley
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206 509-688-0037 - Fax
For Inspections, call 509-688-0054
Mechanical Permit A
PROJECT
R OF WITS
PERMIT
COST EQUALS AMOUNT
ADDRESS: 1
-OR<100,000
USE:
$15
OWNER:
Al
PHONE (Daytime Contact): �(
MAILING ADDRESS:_404
3 UNLISTED APPLIANCE(ADDITIONAL FEE)
-OR<400,"
Ir
eC
1 v
(street)
(dty/stat)
(ZIP)
CONTRACTOR:
. or <400,000
LICENSE 9:
850
6 USED APPLIANCE(WSEC min. AFUE rating)
>400,000
X
�8 G
MAILING ADDRESS:
PHONE P
X
815 -
8 BOILERBIEFRIGERATION
101- 500M BTU
l7z
( -A
4
(street)
(city/state)
(ZIP)
METHOD, OF PAY,
❑ CASH ❑ CI
DATE:
DESCRIPTION OF WORK
R OF WITS
X
COST EQUALS AMOUNT
I FUEL BURNING APPLIANCE
-OR<100,000
X
$15
2 FUEL BURNING APPLIANCE
> 100,000
X
$19
3 UNLISTED APPLIANCE(ADDITIONAL FEE)
-OR<400,"
x
$50
4 UNLISTED APPLIANCE (ADDITIONAL FEE)
>400,000
X
8100 -
5 USED APPLIANCE (WSEC I. AFUE rating)
. or <400,000
x
850
6 USED APPLIANCE(WSEC min. AFUE rating)
>400,000
X
8100
7 BOILER/REFRIGERATION
1-100M BTU
X
815 -
8 BOILERBIEFRIGERATION
101- 500M BTU
X
$a
9 BOILERMEFRIGERATION
501-1,000M BTU
X
839-
10 BOILER/REFRIGERATION
1001-1,750M BTU
X
857
11 BOILER/REFRIGERATION
-1750M BTU
X
895
12 GAS LOG, GAS INSERT, GAS FIREPLACE
X
810
13 RANGE
X
810 -
14 DRYER
X
810 -
15 FUEL BURNING WATER HEATER
-
X
810
16 MISC. FUEL BURNING APPL.
-
X
810
17 GAS PIPING (ea. Outlet)
X
81
18 DUCT SYSTEMS
X
810
19 VENTILATING FANS
X
810
20 AIR HANDLER (DOES NOT include duc g)
-OR<10,000CFM
X
812
21 AB HANDLER (DOES NOT mdude duding)
> 10,000 CFM
X
819
22 EVAPORATIVE COOLERS
X
810
-L TYPE IHOOD
x
$IN
24 TYPE R HOOD
X
810 -
25 HEAT PUMP/AIR CONDITIONER
0-3 TON
X
812 -
26 AIR CONDITIONER
3-15 TON
X
820
27 AIR CONDITIONER
15-30 TON
X
S25
28 AIRCONDITIONER
30-50 TON
X
S35
29 AIR CONDITIONER
-50 TON
X
860
30 LPGSTORAGETANK
X
$10 -
31 WOOD OR PELLEPSPOVEANSERT
X
810 -
32 WOOD STOVE -FREESTANDING
X
$25
BENT
TECK n
SUBTOTAL:
PLUS PROCESSING FEE $35.00
TOTAL PERMIT FEE DUE
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
EXPIRES: