2011, 08-18 Permit App: 11002502 Sewer.'Spiikane
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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
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PERMIT NUMBER: / (^2470Z__
PERMIT FEE:
n Commercial n Residential
SITE ADDRESS:
Building Owner _
Name. �a d n // /e)/ G Phone: Fax:
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Zip:
- Address rJ /7 ' r'
1/ S "9C a City. 5p6,,, v, State: Li}
Contractor ACC
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Name:/ Phone: Fax:
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Address: /� f../7 A-(.26 y ‘,/}‘,/}%
City: ft„ 6.0 , State: )V R Zip: (-) 2;34 LTJ
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License No: d,C4)/ /y,/orj City Business s Lie.
Contact/Project Manager:
Phone: .20,2L "' G J L L�
Name:..X/ Pl24- »l/ 5'L(�,
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# OF UNITS
UMBING FIXTURE ON A TRAP
(LETS
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
WATER USING DEVICE
Ice and/or Coffee maker, hose bib, steamer merger, 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
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['CASH D CHECK D VISA 0 MC
Card#
SIGNATURE:
EXPIRES:
VIN:
CURRENT FEES AVAILABLE AT: http:/lwww.spokanevalleyorq/ under the quick links for Forms, Master Fee Schedule.
http://wwwspokanevalley.org/uploads/Communtty_Development/Documcnts/Forms/Building/Plumb ingPermitAppl ication040309.doc