2014, 05-29 Permit App: BLD-2014-1222 Sewer ReversalPermit Center
*altgn* 11703 E Sprague Ave, Suite B-3
4000 %. Spokane Valley, WA
6
(509)688-00366FAX
FAX (509)688-0037
permiteenterkitspokauevallev.org
Community Development
Plumbing Permit Application p �/
S TE ADDRESS: 7�O / ' , < wet! S� i
PERMIT NUMBER:
PERMIT FEE:
0 Commercial 1Residential
❑CASH ❑ CHECK ❑ VISA ❑ MC
Card#
SIGNATURE
EXPIRES:
VIN:
CURRENT FEES AVAILABLE AT: httpi/www.spokanevafey.orat under the quick links for Forms, Master Fee Schedule.
Building Owner
Name: //€ I/l e r)C X /e e/ 1- Phone. g /�j f " / / �? ,C/'D Fav
Address:��� ,,�
J` City: State: Zip:
Contractor •
Name: 'La r r /Y) T e r Exc. i n C_ Phone: c dp . 1 aeo Fas q u a- 5010
Address: .711 E. w+4 e f A ve. City
i f�v State: ti _IA Zip: 17.114
Licessnse No- City i1�i
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LA R Ry 4.)E �` 7 r NT
Lic:
Co7etact/Project Manager:
Project # iP'-.0 la- t 2-22--
rte: Phono:
RFC:FIVFn
# OF TS
UNI
PLUMBING FIXTURE ON A TRAP
//--
MAY 2 ! 21314
TOILETS
URINALS
CSV PERMIT CENTER
TUBS
-
SHOWERS (per trap)
SUB `
I V. t
Lav/Basins, Bar, Floor,
p
SINKS
-
Prep/Culinary Meat
Fes} .—...--1
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
IF/4 &la 1A Installation, Alterations, Repav/Reversatse we j^ /
WATER USING DEVICE
Ice and/or Coffee maker, hose bib, steamer proofer, carbonator, swamp coop
PRIVATE SEWAGE DISPOSAL SYSTEM
WATER HEATER
If Gas, See Meriranical
INDUSTRIAL WASTE PRETREATEMENT
INCEPTORS
Including traps, vents except kitchen type grease interceptors functioning as fixture traps
REPAIR OR ALTERATION
Water ping, drainage or vent piping
ATMOSPHERIC TYPE VACUUM BREAKER
BACK FLOW PROTECTIVE DEVICE
Other than atmospheric type vacuum breakers
MEDICAL GAS
INCEPTORS
❑CASH ❑ CHECK ❑ VISA ❑ MC
Card#
SIGNATURE
EXPIRES:
VIN:
CURRENT FEES AVAILABLE AT: httpi/www.spokanevafey.orat under the quick links for Forms, Master Fee Schedule.