2009, 08-04 Permit App: 09002405 Plumbing FixturescossOey.
M1
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
permitcenterc sookanevallev.or¢
Community Development
Plumbing Permit Application
cSacke> , Sr. LAW, Y
SITE ADDRESS:
PERMIT NUMBER: 9 c2YQS
PERMIT FEE:
n Commercial
Residential
Building Owner:..; _
Name
Phone: Fax:
I J \-\ WoleukCe
Address- City State: Zip:
c� /
Contractor ,I'Sb(if 6 (S c \C,t..l+-t (r,`'
Name' Phone: Fax:
Address: City: State: Zip:
p� , �,r�
License No: O G 'L CL.C+Y° City Business Lic: ya�
Contact/Project Manager: ",
�], /y �,: ,
,� +�1y_1�,p—V-
Name' A. 3'c1ci�`-IJ Vi Phone: s O coJ Cr)—U\ v� D3
vVl s
# OF UNITS
PLUMBING FIXTURE ON A TRAP
TOILETS
URINALS
TUBS
SHOWERS (per trap)
SINKS
Lav/Basins, Bar, Floor, Kitchen, Laundry, Utility, Janrtor, Photo, X-ray, Food,
Prep/Culinary Meat
5—
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, Alterabons, 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
I
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 ❑ MC
Card#
SIGNATURE:
EXPIRES:
VIN.
CURRENT FEES AVAILABLE AT http //www spokanevalley orq/ under the quick links for Forrns, Master Fee Schedule
http.//wwwspokanevalley.orghploads/Community Development/Documents/Forms/BuildinWPlumbmgPermitAppl ication040309.doc