2012, 06-19 Permit App: BLD-2012-0928 Plumbing Fixtures*rim
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Community Development
Plumbing Permit Application
11 ZZ E Ccd ,Ida
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
permitcenter a snokanevalley.org
SITE ADDRESS:
PERMIT NUMBER:
PERMIT FEE:
n Commercial Residential
['CASH ❑ CHECK 0 VISA 0 MC
Card
SIGNATURE
EXPIRES:
VIN:
Project # taic rZ _CQ, -%
RECEIVED
AIN 19 2012
GG IIR1 CSV PERMIT CENTER
CURRENT FEES AVAILABLE AT:http://www.spokanevalley.orq/ under the quick links for Form,tJl"asf2YFe ch dule REV #Enj
http J/wwwspokanevalley.org/uploads/Community_Development/Documents/Forms/Bui Iding/PI umbingPermitAppl ication040309. doc
Building Owner t^,,` �
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Name: di? (4 (Ai l JI YCr Se Phone: Zl�-!/Zi/T Fax: ( y-s5g`C'
Address: ? 6. I ctx- toil la City: 9v0 t[✓LC State: wc Zip: 99 )
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Contractor q e
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Name: Phone: Fax:
Address: City: State: Zip:
License No: City Business Lic:
Contact/Project Manager: -
Name: 5 tile..., Phone:
# OF UNITS
PLUMBING FIXTURE ON A TRAP
( 4C(o d•13 7o r4cuP,
TOILETS
-S—
/
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URINALS
TUBS
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SHOWERS (per trap)
SINKS
Lav/Basins, Bar, Floor, Kitchen, Laundry, Utility, Janitor, Photo, X-ray, Food,
Prep/Culinary Meat
DISHWASHER
CLOTHES WASHER
GARBAGE DISPOSAL
1
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
1
PRIVATE SEWAGE DISPOSAL SYSTEM
/
WATER HEATER
If Gas, See Mechanical
1
INDUSTRIAL WASTE PRETREATEMENT
INCEPTORS
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
r —
_
['CASH ❑ CHECK 0 VISA 0 MC
Card
SIGNATURE
EXPIRES:
VIN:
Project # taic rZ _CQ, -%
RECEIVED
AIN 19 2012
GG IIR1 CSV PERMIT CENTER
CURRENT FEES AVAILABLE AT:http://www.spokanevalley.orq/ under the quick links for Form,tJl"asf2YFe ch dule REV #Enj
http J/wwwspokanevalley.org/uploads/Community_Development/Documents/Forms/Bui Iding/PI umbingPermitAppl ication040309. doc
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