2011, 12-06 Permit Application: 11003814 Water Heaterrte. r�r�!�.il1e
o Valley
Permit Center
11703 E Sprague Ave, Suite B -3
Spokane Valley, WA 99206
(509)688 -0036 FAX: (509)688 -0037
perm itcenter a spokaneval lev.org
Community Development
Plumbing Permit Application
PERMIT NUMBER: 11. -34g 1 L(
PERMIT FEE:. 3e
n Commercial tzf Residential
SITE ADDRESS: 4701/ N Adam S Ld
Building Owner
Name: 10;11 000( Phone: (I� // �/�G,9 Fax:
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Address: L/-7 .21 N A o'i ,i CW City: 5100 /i/h a i/ /fey State: am Zip: 4'9w
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Contractor
Name: ( Phone: Fax:
Sao /Y1 A /l -'S_� �5"/ — GSv
Address: 52 Z O /t/ // C'Ty: So 04Gn e State: w,�} Zip: 99 ,2/Z
License No: 'SPo A/ 1O (j /2 ��_ City Business Lic: �/e S
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Contact/Project Manager: !
Name: Wr ih aKA Phone: 7 �',2/f "- ,Itig4(
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# OF UNITS
PLUMBING FIXTURE ON A TRAP
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
Area, Case, Coil, Trench, Condensate
ROOF DRAIN /OVERFLOW DRAINS
FOUNTAIN, DRINKING
WATER PIPING /DRAIN -IN WASTE
Installation, Alterations, Repair, Reversals
WATER USING DEVICE
Ice and /or Coffee maker, hose bib, steamer proofer, carbonator, swamp cooler
PRIVATE SEWAGE DISPOSAL SYSTEM
WATER HEATER
If Gas, See Mechanical
INDUSTRIAL WASTE PRETREATEMENT
INCEPTORS
Including traps, vents except kitchen type grease interceptors functioning as fixture traps
REPAIR OR ALTERATION
Water piping, drainage or vent piping
ATMOSPHERIC TYPE VACUUM BREAKER
BACK FLOW PROTECTIVE DEVICE
Other than atmospheric type vacuum breakers
MEDICAL GAS
INCEPTORS
❑CASH ❑ CHECK ❑ VISA ❑ MC EXPIRES:
Card# VIN:
SIGNATURE:
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