2011, 05-31 Permit App: 11001539 SinkSpokane
Valley
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
perrnitcenterAspokanevalley.org
Community Development
Plumbing Permit Application
SITE ADDRESS:
PERMIT NUMBER:
PERMIT FEE:
Commercial Residential
Building Owner 30 ,..C. L (k) i L 50)\3
Narne: J4irt, Phone: ...?6a_ (oci 0 Fax:
Address: City: s->po ita n e..._ State: Zip:
Contractor s , et 0 (31., U (14 0 / Aj6
/Cf. 8.2‘ -C6 Fax:
Name: PI, c s R. 4e. G/e0 Oi Phone: /
,S'c_k,i
Address:
7? c. S-A,./...-kiciA City: zoirs &I i C State:(,(, iir Zip:
License No: So IOL u *0 / 1 .0 /1 City Business Lic:
Contact/Project Manager:
Name: Phone:
# OF UNITS
PLUMBING FIXTURE ON A TRAP
TOILETS
URINALS
TUBS
SHOWERS (per trap)
4 SINKS
Lav/Basins, Bar, Floor, Kitchen, Laundry, Utility, Janitor, Photo, X-ray, Food,
Pre./Culina 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
Ice and/or Coffee maker, hose bib, steamer proofer, carbonator, swamp cooler
WATER USING DEVICE
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
Water piping, drainage or vent piping
REPAIR OR ALTERATION
ATMOSPHERIC TYPE VACUUM BREAKER
BACK FLOW PROTECTIVE DEVICE
Other than atmospheric type vacuum breakers
MEDICAL GAS
INCEPTORS
['CASH D CHECK DVISA DMC
Card#
SIGNATURE:
EXPIRES:
VIN:
CURRENT FEES AVAILABLE AT: http://www.spokanevalley.orq/ under the quick links for Forms, Master Fee Schedule.
http://www.spokancvalley.org/uploads/Community_DeveloPment/Documents/Forrns/Building/PlumbingPermitApplication040309.doc