2004, 02-23 Permit App BLD-04-03596 Plumb ReversalMETHOD 0
0 CASH
San <shne
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: 9g! i ( 24 /J �� %
LLlPv//r
PERMIT
USE:
OWNER
PHONE (Daytime Contact): �?)_ a✓t-',/
2 74 V
MAILING A✓�'I/�RESS:�% _/ 1 %�// %� C/�1 �7�/
27-1 i (' of / /ICJ �/ �6✓ y // cY G /' i /// C"_ / 9i7'U/
(street) (city/state) / (ZJP)
CONTRACTOR: ,r J7)
/
LICENSE #:
MAILING ADDRESS:
PHONE #:
(street) (city/state) (Zll')
PLUMBING FIXTURES
DETAILS
# OF UNITS
X
COST
EQUALS
AMOUNT
DESCRIPTION
1
TOILETS
WATER CLOSET, BIDETS
i-t
X
S6
2
URINALS
X
$6
-
3
TUBS
•,14
X
$6
-ta
SHOWERS (PER TRAP)
BATH, STALL ON -SITE BUILT
• 1`
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
SEWAGEEJECIOR
GRINDER SUMP PUMP
X
$b
-
15
WATER USING DEVICE
ICE AND/OR COFFEE MAKER, HOSE BIB,
STEAMER ?ROOFER, CARBONATOR,
SWAMP COOLER
X
$6
-
16
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE, AND
RP.B.P.D. FOR: VATS, TANKS, BOILERS
X
$6
17
X
$25
-
SPRINKLER SYSTEM
18
INTERCEPTORS
GREASE TRAP, SAND TRAP, CHEMICAL
X
86
-
HOLDING TANK
19
MEDICAL GAS per outlet
NITROUS, OXYGEN
X
$6
-
20
MISC. PLUMBING FIXTURE
X
$6
-
PAYMENT
CHECK
allia y;xq
Ward '
I .:..._�_`._
SUBTOTAL:
PLUS PROCESSING FEE:
$35.00
• ❑
TOTAL PERMIT FEE DUE:
DATE: EXPIRES:
BANKCARD NUMBER
AUTHORIZED SIGNATURE:
Spokane
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 Application
PROJECT
ADDRESS:
PERMIT
USE:
OWNER:
PHONE (Daytime Contact):
MAILING ADDRESS:
(street)
(city/state) (GIy)
CONTRACTOR:
LICENSE #:
MAILING ADDRESS:
PHONE #:
(street)
(city/state) (ZIP)
METHOD OF PA
❑CASH ❑c
DESCRIPTION OF WORK
4 OF UNITS
X
COST
EQUALS
AMOUNT
1
FUEL BURNING APPLIANCE
- OR <100,000
X
$15
-
2
FUEL BURNING APPLIANCE
>100,000
X
$19
-
3
UNLISTED APPLIANCE (ADDTIONAL FEE)
- OR <400,000
X
$50
-
4
UNLISTED APPLIANCE (ADDITIONAL FEE)
>400,000
X
$100
5
USED APPLIANCE (WSEC min. AFUE rating)
- or <400,000
X
$50
-
6
USED APPLIANCE (WSEC min. AFUE rating)
> 400,000
X
8100
-
7
BOILER/REFRIGERATION
1-100M BTU
X
$15
-
5
BOILER/REFRIGERATION
101 - 500M BTU
X
$28
-
9
BOILER/REFRIGERATION
501-L000M BTU
X
839
10
BOILER/REFRIGERATION
1001- 1,750M BTU
X
$57
11
BOILER/REFRIGERATION
+1750M BTU
X
895
-
12
GAS LOG, GAS INSERT, GAS FIREPLACE
-
X
810
-
13
RANGE
-
X
510
14
DRYER
-
X
$10
•
15
FUEL BURNING WATER HEATER
-
X
810
-
16
MISC FUEL BURNING APPL.
-
X
$10
-
17
GAS PIPING (ea. Outlet)
-
X
$1
-
18
DUCT SYSTEMS
-
X
$10
-
19
VENTILATING FANS
-
X
$10
-
20
AIR HANDLER (DOES NOT include ducting)
• OR<10,000CFM
X
$12
21
AIR HANDLER (DOES NOT include ducting)
> 10,000 CFM
X
$19
-
22
EVAPORATIVE COOLERS
-
X
$10
-
23
TYPE IHOOD
-
X
$50
-
24
TYPE II HOOD
-
X
510
-
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
X
$12
-
26
AIRCONDITIONER
3-15 TON
X
$20
-
27
AIR CONDITIONER
15-30 TON
X
$25
-
28
AIR CONDMONER
30-SO TON
X
$35
-
29
AIR CONDITIONER
+50 TON
X
860
-
30
LPG STORAGE TANK
-
X
$10
-
31
WOOD OR PELLET STOVE/INSERT
-
X
810
-
32
WOOD STOVE -FREESTANDING
-
X
525
-
4fENT
If
—
SUBTOTAL:
PLUS PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: