2011, 04-28 Permit App: 11001099 PlumbingSpokane
jVlleyk
Community Development
Plumbing Permit A
Permit Center
11703 E Sprague Ave, Suite B -3
Spokane Valley, WA 99206
(509)688 -0036 FAX: (509)688-0037
permitcenter@spokanevallev.org
I' ' I d 9 4 NUMBER:
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❑ Commercial 1#11 Residential
SITE ADDRESS: X V
f 11r 14
Building Owner
LJCASH ❑ CHECK ❑ VISA ❑ MC EXPIRES:
Card# VIN:
SIGNATURE:
CURRENT FEES AVAILABLE AT: http: / /www.spokanevallev.org/ under the quick links for Forms, Master Fee Schedule.
http: / /www.spokanevalley.orgluploads /Community Development / Documents / Forms / Building/ PlumbingPermitApplicationO4O3O9 .doe
Name: t` Phone: So _ b 7 S�� Fax:
Address: b 7
E: City: E L State: G✓ Zip: g 4
Contractor W.
Name: Phone: Fax:
Address: City: State: Zip:
License No: City Business Lic:
Contact/Project Manager:
Name: Phone:
# 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 Prpp/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
j
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 trans vents exce t kitchen a rease interce tors functioning as fixture traps
REPAIR OR ALTERATION
Water nininn , drains a or vent i in
ATMOSPHERIC TYPE VACUUM BREAKER
BACK FLOW PROTECTIVE DEVICE
Other than atmospheric type vacuum breakers
MEDICAL GAS
INCEPTORS
LJCASH ❑ CHECK ❑ VISA ❑ MC EXPIRES:
Card# VIN:
SIGNATURE:
CURRENT FEES AVAILABLE AT: http: / /www.spokanevallev.org/ under the quick links for Forms, Master Fee Schedule.
http: / /www.spokanevalley.orgluploads /Community Development / Documents / Forms / Building/ PlumbingPermitApplicationO4O3O9 .doe