2014, 06-09 Permit App: BLD 2014-1319 Sewer ReversalPermit Center
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PERMIT NUMBER
_m Spokane Valley, W
�r (509)688-0036 F
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• (509)688-003F1 E C E 1 V E D
PERMIT FEE: y g. '0 U
Commrmity Development
Plumbing Permit Application
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2014
JUN 9
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Commercial %Residential
SITE ADDRESS: � 3 1VPL
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Building Owner
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Phone-77,77;-77-73"'"'//Roc
Name: . jCG iiL Y rV C ! -
Address: S�,I.,, or Cm. S•e, LAG Jre YState: ie? �pa3�
Contractor
Name: LAC ("%i I to FXc.1x1G7A4,._ Phone: �' !dace Fax 9 as - 5010
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Address: •'7 i i % E- R
a+i e f A Ve City . iA State' WA Zip: `I 9a 107 .
License No: L 4 R Ry /h E 71-APT City Bi �iniss Lie:
Contact/Project Manager.
Name: Phone:
# OF UMTS
PLUMBING FIXTURE ON A TRAP
TOILETS
URINALS
TUBS
-
SHOWERS (per trap)
SINKS
Lav/Basins, Bar, Floor, Itchen, Laundry, Wily, Janitor, Photo, X-ray, Food,
Prep/Culinary Meat
DISHWASHER
CLOTHES WASHER
GARBAGE DISPOSAL
WATER SOFTNER
FLOOR DRAIN
Area, Case, Col, Trench, Condensate
ROOF DRAIN/OVERFLOW DRAINS
FOUNTAIN, DRINKING
WATER PIPING/DRAIN-IN WASTE
fft/J Pj Ii [ w Installation, Alterations, RepelRetersals 5e-w r
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
INDUSTRIAL WASTE PREFREATEMENT
INCEPTORS
Including baps, 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
❑CASH ❑ CHECK ❑ VISA ❑ MC
Card#
SIGNATURE:
EXPIRES:
VIN:
CURRENT FEES AVAILABLE AT: http://www.spokanevafiey.org/ under the quick finks for Forms. Master Fee Schedule.