2011, 04-13 Permit App: 11000924 Plumbing FixturesSpokane
Valley
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
permitcenter@spokanevallev.org
Community Development
Plumbing Permit Application
SITE ADDRESS:
PERMIT NUMBER: ' `0,_ J
PERMIT FEE:
n Commercial g] Residential
ry ios- G. Boc.N-e---
Building Owner
Name: jv (a144 (Ir. Keg 6g PJ-{- Phone: Fax:
Address: 1 4 t J 66 /.^2� City: J�-P ^e— State: (L) cam. Zip:
Contractor
Name: Phone: Fax:
M As �'(, �v✓10 1"N � 5 �`� 3� z S► d 0
Address: 9 at (4, j yof L d City: yc c• State: Zip: ��
qt
License No: M A f RT47 9 i L 4 City Business Lic:
Contact/Project Manager:
Name: Phone:
# OF UNITS
PLUMBING FIXTURE ON A TRAP
TOILETS
2 -
URINALS
TUBS
SHOWERS (per trap)
1(
`
SINKS
Lav/Basins, Bar, Floor, Kitchen, Laundry, Utility, Janitor, Photo, X-ray, Food,
Prep/Culinary Meat
DISHWASHER
l
CLOTHES WASHER
l
GARBAGE DISPOSAL
WATER SOFTNER
i%
FLOOR DRAIN
Area, Case, Coil, Trench, Condensate
ROOF DRAIN/OVERFLOW DRAINS
FOUNTAIN, DRINKING
,.5�
�J
WATER PIPING/DRAIN-IN WASTE
Installation, Alterations, Repair, Reversals
R./
WATER USING DEVICE
Ice and/or Coffee maker, hose bib, steamer proofer, carbonator, swamp cooler
/
PRIVATE SEWAGE DISPOSAL SYSTEM
-gr./
WATER HEATER
If Gas, See Mechanical
INDUSTRIAL WASTE PRETREATEMENT
INCEPTORS
Including traps, vents except kitchen type grease interceptors functioning as fixture traps
�X
)
REPAIR OR ALTERATION
Water piping, drainage or vent piping
0
ATMOSPHERIC TYPE VACUUM BREAKER
BACK FLOW PROTECTIVE DEVICE
Other than atmospheric type vacuum breakers
MEDICAL GAS
6 -
INCEPTORS
a
❑CASH ❑ CHECK VISA ❑ MC
Card#
SIGNATURE:
EXPIRES: 0577 3
VIN:
CURRENT FEES AVAILABLE AT: http://www.spokanevalley.org/ under the quick links for Forms, Master Fee Schedule.
http://www. spokanevalley.org/uploads/Community_Development/Documents/Forms/Building/PlumbingPermitApplication040309.doe