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2010, 04-15 Permit App: 10001037 Water Piping
Spokane ` Valey' Permit Center 11703 E Sprague Ave, Suite B-3 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 permitcenterraspokanevalley. org Community Development Plumbing Permit Application (3-103' PERMIT NUMBER: PERMIT FEE: Commercial Residential SITE ADDRESS: CKVAj ,no Building Owner ,,.: r': ':- , ., ., ger :..: •.., r- Name: )-/-\ ''f21— C \ pi\'A I'.S I \1 Phonee0p0c1 5 z 4 4 14 \ Fax: tV sSs-�� Address: ) `� Q, or) E. �- P�Aj-TA Ci CIO �`Q. '� / A1—I)- tate VTA Zip:f 1,�_4 Contractor ... .. t.,.,:.::..:..-.._._.,,,:,i.....'� .... ,.... - .. . Name: Phone: Fax: NaI�E o�rSE� Address: City: State: Zip: License No: City Business Lie: Contact/Project Manager , , - : ... .. ;; Name: Phone: # OF UNITS PLUMBING FIXTURE ON A TRAP TOILETS URINALS . TUBS SHOWERS (per trap) SINKS Lav/Basins, Bar, Floor, Kitchen, 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, Repai4 Reversals " f 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 ['CASH 0 CHECK ,,VISA 0 MC Card# SIGNATURE: EXPIRES: VIN: CURRENT FEES AVAILABLE AT: http://www.spokanevalley.orq/ under the quick links for Forms, Master Fee Schedule. http://wwwspokanevalley. org/uploads/Communily_Development/Documentt/Fomes/Building/Plumb ingPermi LAppl ication040309. doe