2012, 07-06 Permit App: BLD-2012-1039 Plumbing FixturesPermit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
permitcenternu spokanevallev orp
Community Development
Plumbing Permit Application
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PERMIT NUMBER:
PERMIT FEE:
❑ Commercialesidential
SITE ADORNSS:
T/12/g T C3r)ovic.
Building Owner
Name: /1,6- //S r�u", a, Phone: Fax:
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Address: City: State:
Zip:
Contractor
Name: /' ///� Phone: 9 r� Fax:
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Address. /� / / Ci Slate: Ti,
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License No: �l $ alP�CJ 1 ` i 7 City Business Lie: .
Contact/Project anager:
Name: n % Phone: co y _2 ,..a 7v7! C
L1/ / O
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# 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
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
J
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
DCASH 0 CHECK ❑ VISA ❑ MC
Card#
SIGNATURE:
EXPIRES:
VIN:
P:\Community Development\02 Administration\03 Forms - ODicial Versions\Perm't Center\Plumbing Permit Application 04-03-09 dg.doc