2004, 09-09 Permit App BLD-04-07600 Plumb Reversals�iC40,1/alley
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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
Project Address: //'// /'r„ / /c Permit Use:
Owner: e f
�r.,2l-7/(//
Mailing Address:
Contractor.
Mailing Address:
/42.4-2— �,� A (, ,_ License #:
"30 2 / ////(
C.
Phone (Daytime Contact):
State Zip Code
Phone #: /-65Z5S'
city
City
State
5 > ,
Zip Code
DESCRIPTION OF WORK
# OF
NITS
X
COST
=
TOTAL
AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
56.00
=
2
URINALS
X
56.00
=
3
TUBS
X
56.00
=
4
SHOWERS PER TRAP)
BATH, STALL ON -SITE BUILT
X
56.00
=
5
SINKS
LAVS/BASINS, BAR, FLOOR,
KITCHEN, LAUNDRY, UTILITY,
JANITOR, PHOTO, X-RAY, FOOD,
PREP/CULINARYlMEAT
X
56.00
=
6
DFSHWASHER
X
56.00
=
7
CLOTHES WASHER
X
56.00
=
8
GARBAGE DISPOSAL
X
56.00
=
•
9
WATER SOFTENER
X
56.00
=
10
ELECTRIC HOT WATER TANK
NOTE IF GAS, SEE MECHANICAL
X
56.00
=
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH,
CONDENSATE
X
56.00
=
12
ROOF DRAINS/OVERFLOW DRAINS
-
X
56.00
=
13
FOUNTAINS, DRINKING
X
$6,00
=
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
INSTALLATION, ALTERATION,
REPAIR, REVERSALS
X
X
56.00
=
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
' X
56.00
=
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER,
HOSE BIB, STEAMER, PROOFER,
CARBONATOR, SWAMP COOLER
X
56.00
=
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK "
VALVE, ANDRP_B.P.D. FOR
VATS, TANKS, BOILERS
X
56.00
,
' 18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
56.00
=
19
MEDICAL GAS per outlet)
NFTROUS, OXYGEN
X
t $6.00
=
20
MISCELLANEOUS PLUMBING FIXTURE
I
X
56.00
=
-
METHOD OF PAYMENT:
❑ CASH D CHECK ❑ VISA Q MASTERCARD
DATE EXPIRES:
SUBTOTAL
PROCESSING FEE
535.00
t TOTAL PERMIT FEE DUE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
Contractor: License #:
Mai ing Address:
MECHANICAL PERMIT APPLICATION
City of Spokane Valley Comirtuaity Development Department
BuildingDivision
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688-0036,- Fax: (509) 686-0037
FOR INSPECTIONS,. CALL (509) 688-0054
Project Address: Permit Use:
Owner.. Phone (Daytime Contact):
Mailing Address:
Zip Code
City
State
Phone#:
C
State
DESCRIPTION OF WORK
S OF
UNITS '
X
COST
=
TOTAL
AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
X
$15.00
=
"-2--FUECBURNtNG-APPLANCE
more iffir1110,000
X
$19.00
=
3
UNLISTED APPLL NCE (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 oriess than 400,000
X
350.00
=
6
USED APPLIANCE (WSEC min. AFUE
rating)
More than40O,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 -1750M BTU
X I
$57.00
=
tt
BOB.ERIREFRIGERATiION
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
St0.o0
=
15
FUEL BURNING WATER HEATER
X
$10.00
=
16
MISC. FUEL BURNING APPLIANCE
X
$10.00
=
17
GAS PIPING (each outlet)
X
S1.00
=
18
DUCT SYSTEMS
X
c+0_00
_
19
VENTIIATING 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
S19.00
=
22
EVAPORATIVE COOLERS
X
$10.00
23
TYPE I HOOD
X
$50.00
=
24
TYPE It HOOD
X
$10.00
=
25
HEATPUMP/AIR CONDITIONER
' O3 TON
X
51200
=
26
AIRCONDIONER
3-15 TON
X
$20.00
=
27
15-36TON
X
$25.00
=
AIR CONDITIONER
28
AIR CONDITIONER
30-50TON
-
X
$35.00
=
29
AIR CONDITIONER
More Mar; 56TON -
X
$60.00
=
30
LPG STORAGE TANK
-
X
$10.00
=
• 31
WOOD OR PELLET STOVE/INSERT
X
1
• $10.00
=
32
X
$25.00
=
WOOD STOVE - FREE STANDING
METHOD OF PAYMENT:
Q CASH 0 CHECK 0 VISA 0 MC
CARD
CARD tit
DATE:
SUBTOTAL
PROCESSING FEE
$35.00
EXPIRES:
FEE DUE
.Zip Code
AUTHORIZED SIGNATURE: