2010, 03-03 Permit App: 10000576 Mechanical FixturesSpokane
Va"'_yx
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
permitcentera spokanevall ev. org
PERMIT NUMBER: (0 _ c
PERMIT FEE: LI
Community Development
Plumbing Permit Application /,, Fl Commercial [Residential
SITE ADDRESS: #/ s' Cdr �n / c fi z / 1219 / g 2
Building Owner j� �Lo�a 5-;.---0,-it-4 �' e57- l Yc
Name: Phone: Fax:
Address: /5^ q/ 2 % r �{���-,t4!!! �.. gr) City: Sp..es) yt,e State: p (�� 4 Zip: ?(?2(
Contractor 6."-<›eA,t. i L( 63`P.R 1� �` •.� ez.e4:2
Name: J v Phone: Fax:
Address: City: State: Zip:
License No: City Business Lic:
Contact/Project Manager:
Name: Phone:
# OF UNITS
PLUMBING FIXTURE ON A TRAP
TOILETS
i
URINALS
TUBS
i
SHOWERS (per trap)
SINKS
Lav/Basins, Bar, Floor, Kitchen, Laundry, Utility, Janitor, Photo, X-ray, Food,
Prep/Culinary Meat
DISHWASHER
i
CLOTHES WASHER
1
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
Ili
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
REPAIR OR ALTERATION
Water piping, drainage or vent piping
1
ATMOSPHERIC TYPE VACUUM BREAKER
BACK FLOW PROTECTIVE DEVICE
Other than atmospheric type vacuum breakers
MEDICAL GAS
INCEPTORS
❑CASH 0 CHECK ❑ VISA ❑ MC EXPIRES:
Card# VIN:
SIGNATURE:
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