2012, 04-24 Permit Application: BLD-2012-0464 Ejectoroka e
4000 Valley
remit Lenter
11703 E Sprague Ave, Suite B -3
Spokane Valley, WA 99206
(509)688 -0036 FAX (509)688 -0037
permitcenter(a,spokanevailey. org
Community Development
Plumbing Permit Application
�TTE ADDRESS:
/sunning owner- -
Name:
G ,c, c")
Address:
a
rt
PERMIT NUMBER: 8 id—
PERMIT FEE: -4/ ,?) st-c2 X
[1 Commercial ❑ Residential
Address:
License No:
City:
State:
Zip:
Contact/Project Manager:
Name:
City Business Lic:
Phone:
PLUMBING FIXTURE ON A TRAP
# OF UNITS
TOILETS
URINALS
TUBS
SHOWERS (per trap)
SINKS
Lav /Basins, Bar, Floor, Kitchen, Laundry, Utility, Janitor, Photo, X -ray, Food,
Prep /Culinary Meat
DISHWASHER
CLOTHES WASHER
GARBAGE DISPOSAL
WATER SOFTNER
FLOOR DRAIN
ROOF DRAIN /OVERFLOW DRAINS
FOUNTAIN, DRINKING
WATER PIPING /DRAIN -IN WASTE
WATER USING DEVICE
Area, Case, Coil, Trench, Condensate
Installation, Alterations, Repair, Reversals
PRIVATE SEWAGE DISPOSAL SYSTEM
WATER HEATER
INDUSTRIAL WASTE PRETREATEMENT
INCEPTORS
REPAIR OR ALTERATION
ATMOSPHERIC TYPE VACUUM BREAKER
BACK FLOW PROTECTIVE DEVICE
MEDICAL GAS
INCEPTORS
Ice and /or Coffee maker, hose bib, steamer proofer, carbonator, swamp cooler
If Gas, See Mechanical
Including traps, vents except kitchen type grease interceptors functioning as fixture traps
Water piping, drainage or vent piping
Other than atmospheric type vacuum breakers
1
DCASH ❑ CHECK ❑ VISA ❑ MC EXPIRES:
Card# VIN:
SIGNATURE:
CURRENT FEES AVAILABLE AT: http: / /www.spokanevalley.orgf under the quick links for Forms, Master Fee Schedule.
http: / /www.spokanevalley.org /uploads /Community Development /Documents /Forms/ Building/ PlumbingPermitApp lication040309.doc