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2013, 08-16 Permit App: BLD-2013-1629 Breaker
Community Development eveAstPermit Center 'lane 11703 E Sprague Ave, Suite B-3 Spokane Valley, WA 99206 Vim` PHONE: (509) 720-5240 FAX: (509) 688-0037 Plumbing Permit Application 0JCommercial Residential SITE ADDRESS: /8/ N Ukr,rer /v" ! 3D --//o &4 50K 15,u _zo(3-t69,q PERMIT FEE: t'-13- t6b Building Owner Let /V /50n Phone: s—�F_ -j..33�.6 Fax: Name: LeeJJ'' /V /s0l'1 / Address: / 0) /v. ,9r/Br kOL City: s,-;., , UIQ, State: tY4 Zip: /yew Contractor Name: Phone: Fax: Address: City: State: Zip: License No: City Business Lic: Contact/Project Manager: Name: Phone: # UNITS PLUMBING FIXTURE ON A TRAP TOILETS URINALS TUBS SHOWERS (per trap) SINKS LavBasins, Bar, Floor, ICtchen, Laundry, Utility, Janitor, Photo, X-ray, Food, Prep/Culinary Meat DISHWASHER CLOTHES WASHER GARBAGE DISPOSAL WATERSOFTNER . 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 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 ATMOSPHERIC TYPE VACUUM BREAKER BACK FLOW PROTECTIVE DEVICE Other than atmospheric type vacuum breakers MEDICAL GAS INCEPTORS Signature CURRENT FEES AVAILABLE AT: http://www.spokanevallev.orq/ under the quick links for Forms, Master Fee Schedule.