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2010, 04-22 Permit App: 10001117 Water Piping
Permit Center 11703 E Sprague Ave, Suite B-3 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 pennitcenter(Tsnokanevalley. ore Community Development Plumbing Permit Application l4/4 6 An A- SITE ADDRESS: 5€/f: Li -/1 PERMIT NUMBER: PERMIT FEE: ❑ Commercial i7 Residential / 55 2_0 c Building Owner'.. - , i. - .. Name: lekt.34644 r.4, Phone. Fax: Address- / u//Cj 6,g4;„"y � /i City: �// W6/4 State: 1....--.0 Zip: Zip: zo6 •c Contractor.. _' '.- " . _ , - - - - ___ --- _, Name: !!Y/--r^/��/�i"� /441A,, Phone- z �.� ZZ Far v Address WP wz3&frie City: 6j4# 4,...,. State' /,,4. Zip: 5f7o6 License No: 604,77/.49) 772,aCity Business Lic: Contact/Project Manager:: t:-:... ;, 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 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 f 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 ❑CASH ❑ CHECK 0 VISA 0 MC Card# SIGNATURE: EXPIRES VIN: CURRENT FEES AVAILABLE AT- http://www spokanevalley orq/ under the quick links for Forms, Master Fee Schedule. http.//www.spokanevalley org/uploads/Community_DcvclopmenttDocuments/Forms/Building/PlumbingPermnApplication040309.doc