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2004, 03-04 Permit App BLD-04-03686 Plumb ReversalSpokane Valley Project Address: //6 /O I Owner: 3)2tct- 1-e-)/ Mailing Address: PLUMBING PERMIT APPLICATION City of Spokane Valley Community Development Department BuildingDivision 11707 E. Sprague Avenue, Suite 106 Spokane Valley, WA 99206 Phone: (509) 688-0036; Fax;: (509) 688-0037 FOR INSPECTIONS, CALL (509) 688-0054 COr//5CC Permit Use: Phone (Daytime Contact): City State Zip Code Contractor: DU La Ale! A), , I ytC, License #` Ns_Alagfl73© KPhone #: %% r-5-6S4-/ wait Mailing Address: "1-2O. 9ax l/773,a 596tcz\ C v3C City State DESCRIPTION OF WORK #OF UNITS X COST = TOTAL AMOUNT 1 TOILETS WATER CLOSET, BIDETS X $6.00 2 URINALS X $6.00 = 3 TUBS X $6.00 = 4 SHOWERS (PER TRAP) BATH, STALL. ON -SITE BUILT X $6.00 = 5 SINKS LAVSJBASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X-RAY, FOOD, PREP/CULINARY/MEAT X $6.00 = 6 DISHWASHER X $6.00 = 7 CLOTHES WASHER X $6.00 = 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 X $6.00 = 12 ROOF DRAINS/OVERFLOW DRAINS X $6.00 = 13 FOUNTAINS, DRINKING X $6.00 = 14 INSTALLATION, ALTERATION, REPAIR, REVERSALS X $6.00 = WATER PIPING/DRAIN-IN WASTE, VENT, PLUMBING, REVERSAL 15 SEWAGE EJECTOR GRINDER, SUMP PUMP X $6.00 16 WATER USING DEVICE ICEANJOR 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 = 18 INTERCEPTORS GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK X $6.00 = 19 MEDICAL GAS (per outlet) NITROUS, OXYGEN X $6.00 = 20 MISCELLANEOUS PLUMBING FIXTURE X $6.00 = METHOD OF PAYMENT: ❑ CASH El CHECK ❑ VISA 0 MASTERCARD DATE EXPIRES: SUBTOTAL PROCESSING FEE $35.00 TOTAL PERMIT FEE DUE: BANKCARD NUMBER: Zip Code AUTHORIZED SIGNATURE: �✓ Spokane Wiley Project Address: Owner: Phone (Daytime Contact): Mailing Address: MECHANICAL PERMIT APPLICATION City of Spokane Valley Community Development Department BuildingDivision 11707 E. Sprague Avenue, Suite 106 Spokane Valley, WA 99206 Phone: (509) 688-0036; Fax: (509) 688-0037 FOR INSPECTIONS, CALL (509) 688-0054 Contractor: Mailing Address: Permit Use: License #: City State Phone #: Zip Code Ci State DESCRIPTION OF WORK # OF UNITS X COST = TOTAL. AMOUNT 1 FUEL BURNING APPLIANCE Equal to or less than 100,000 X $15.00 = 2 FUEL BURNING APPLIANCE - More than100.000 X $19.00 = 3 UNLISTEDAPPLIANCE (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 Jess. 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 $15.00 = 8 BOILER/REFRIGERATION 101-500M BTU X $28.00 = 9 BOILER/REFRIGERATION 501 - 1,000M BTU X $39.00 = 10 BOILER/REFRIGERATION 1,001 - 1,750M BTU X $57.00 = tt BOILER/REFRIGERATION More than 1 750M BTU X $95.00 = 12 GAS LOG. GAS INSERT, GAS FIREPLACE X $10.00 = 13 RANGE X $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 DUCTSYSTEMS 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 include ducting) Greater than 10,000 CFM X $19.00 = 22 EVAPORATIVE COOLERS X $10.00 = 23 TYPE I HOOD X $50.00 = 24 TYPE II HOOD X $10.00 = 25 HEATPUMP/AIR CONDITIONER 0-3 TON X $12.00 = 26 AIR CONDITIONER 3-15 TON X $20.00 = 27 AIR CONDITIONER 15-30TON -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 = METHOD OF PAYMENT: Q CASH ❑ CHECK IDVISA (] MC CARD #: DATE: SUBTOTAL PROCESSING FEE $35.00 EXPIRES. TOTAL PERMIT FEE DUE: Zip Code AUTHORIZED SIGNATURE: