2012, 04-17 Permit App: BLD-2012-0399 Plumbing FixturesSpSkando0N.:2'
valley.
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
eo rmitoentcna:spokanevallec ery
Community Development
Plumbing Permit Application
CLO -ton -o
394
PERMIT NUMBER:
PERMIT FEE: ,l(f uts 0/1
E Commercial fill Residential
sn•EADDRESS: 2009 N BELL, SPOKANE VALLEY, WA 99016
Building Owner
Name: MARY ORCUTT Phone Qja- 1ad7J Fax:
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Address: 2009 N BELL ST SPOKANE VALLEY , WA 99016 City S 9Eizi Vzl& . slaw: LUi7 Zip: qq0/lo
/
Contractor
i
Name: Cool at(IQ Phone: �I,/' 7J q / Fax:
�a+.�
Address: City: SP:7le-F_,A... state: WA Zip:
License No: Ge-,, z_ iti -N7 * 7m City Business Lic:
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Contact/Project Manager:
Name: MARY ORCUTT Phone: SU I.-G7g&'--"700g
# OF UNITS
PLUMBING FIXTURE ON A TRAP
TOILETS
I
URINALS
0
TUBS
/
SHOWERS (par 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, Col, Trench, Condensate
ROOF DRAINIOVERFLOW DRAINS
FOUNTAIN. DRINKING
WATER PIPING/DRAIN-IN WASTE
Installation, Alterations, Repair, Reversals
WATER USING DEVICE
Ice and/or Coffee maker, hose bib, steamerproofer, wlbonator, 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
OCASH g CHECK 0 VISA ❑ MC
Card,*
SIGNATURE:
EXPIRES:
VIN:
PdCommunity Developmentl02AdntinistrationW3 Forms - Official Versions\Permit Ccnter\Plumhing Permit Application 04-03-09 dg doe