2011, 06-10 Permit App: 11001635 Plumbing FixturessFnlxa e
assvalley.
Community Development
Plumbing Permit Application
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
permitcenter(lspokanevalley.org
PERMIT NUMBER:
PERMIT FEE:
32-
n Commercial Residential
SITE ADDRESS: 515 5 Bar r
Building Owner
Name: 51�CA.u.1 1 Ocre Phone: yD9,?h/-ot,3l Fax:
Address: 42 S ?),„..r. k r r City: Gre�Aa a re_ State: ; l A Zip: 940167
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Contractor
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
I.
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
i
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, carbonalor, swamp cooler
PRIVATE SEWAGE DISPOSAL SYSTEM
X
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 atmosphenc type vacuum breakers
MEDICAL GAS
INCEPTORS
❑CASH ❑ CHECK ❑ VISA 0 MC EXPIRES:
Garth VIN:
SIGNATURE:
CURRENT FEES AVAILABLE AT: http //www.spokanevalley.org/ under the quick links for Forms, Master Fee Schedule.
http.//wwwspokanevalley.org/uploads/Community_Development/Documents/Fors/Budding/PlumhmgPermitApplication040309 doc