2012, 08-28 Permit App: BLD-2012-1081 Plumbing Fixturesltarie
Vllby.
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
permitcenter(spokanevalley.olg
Community Development
Plumbing Permit Application
SITE ADDRESS: 10_ 2 6, IV, 47;(,,,el'h
PERMIT NUMBER:
PERMIT FEE:
k0 2 — C)C6
Commercial Residential
_S.pc)14",c5(.0
Building Owner
Name: /ay 1- v< ......._s h cz t 1 .i. Phone: (5-0 I W_- 7 - Fax:
c i
Address: i 6J1%, Rue D City: ' c71,(6,t,-L,e v llerState: (,,4//J( Zip: cpc.7c,-)6
Contractor ,-- -. _ 3
Name: 47/A Phone: Fax:
Address: City: State: Zip:
License No: City Business Lic:
Contact/Project Manager:
Name: Phone:
# OF UNITS
PLUMBING FIXTURE ON A TRAP
TOILETS
3
URINALS
TUBS
SHOWERS (per trap)
i
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
t
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
Includin 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 0 CHECK 0 VISA DMC
Card#
SIGNATURE: S eh
EXPIRES:
MN:
CURRENT FEES AVAILABLE AT: http://www.spokanevalley.orq/ under the quick links for Forms, Master Fee Schedule.
http://www.spokanevalley.org/uploads/Community Development/Documents/Forms/Building/PlumbingPermitApplication040309.doc