2012, 08-08 Permit App: BLD-2012-1277 Plumbing FixturesSSiO1 lYe
#Vey.
Permit Center
11703 E Sprague rote B-3
Spokane Valley, A. 206
(509)688-0036 FAX: (509)688-0037
pennitcenter( spokanevallev.org
Community Development
Plumbing Permit Application
SITE ADDRESS: / 7 7 , l N Bt 3-5-/
*MIT NUMBER:
PERMIT FEE:
n Commercial
Residential
Building Owner . � /.//O /1_, CI �/ l //// s/� U ,
!
J/
Name: Phone: s-9 _ 8 Y (`/ Fax: 728 .+. 9-></
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Address: J y ,Z U "1 TSC 4, r �, k `/ City: J � 4o Ar., �. State: �J I� Zip: / 7 7�✓L�
Contractor cz e. //
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
/
! 2
URINALS
TUBS
SHOWERS (per trap)
11.111-110i
SINKS
Lav/Basins, Bar, Floor, Kitchen, Laundry, Utility, Janitor, Photo, X-ray, Food,
Prep/Culinary Meat
DISHWASHER
3
CLOTHES WASHER
GARBAGE DISPOSAL
WATER SOFTNER
. FLOOR DRAIN
Area, Case, Coil, Trench, Condensate
3
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
W
/ 7 7
Project # l /2
DCASH 0 CHECK ❑ VISA D MC EXPIRES:
Card# VIN:
SIGNATURE:
RECEIVED
AUG 0 8 2012
CSV PERMIT CENTER
SUB #1 REV. #
C1 IRRFNT FFFS AVAILABLE AT: htto://www.sookanevallev.orq/ under the quick links ffr
Forms, MasterF e�Schedule.
http://www.spokanevalley.org/uploads/Community Development/Documents/Forms/Build ing/PlumbingPermitAppl ication040309. doc