2011, 11-15 Permit App: 11003619 Drain Connectionkane
.000.
Permit Center
11703 E Sprague Ave, Suite 13-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
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Community Development
Plumbing Permit Application
/ /
SITE ADDRESS: 1- r /V ` afrL i r /ree
PERMIT NUMBER:
PERMIT FEE:
I°l
❑ CommercialResidential
Building Owner
Name. M/ lee_ -TX e ( Phone- -j770—s' 73 Fax:
Address: 2,140 .5-- Ar Cdh fer ,its City: S�nState:
U /lc y K/A Zip: 791 /2
Contractor
Name L kr;/(4,4 (4.p. EA,. c,.... (/G'tllty Phone: 92 Co. /a 00r Fax:
Address '7 / / E ltetr; f e I^ Ave city. 3.7-,,,k f%(47,,. Stale. 1,(7;07 Zip: / / r� (oz
License No: City Business Lic:
Contact/Project blanager:- __
._,M
Name: Ge r r y
�. . //er Phone: '7 / f''- Y ysF
I r
# OF UNITS
PLUMBING FIXTURE ON A TRAP
TOILETS
URINALS
TUBS
SHOWERS (per Trap)
SINKS
LavlBaslns, 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.',
i
FOUNTAIN, DRINKING
—
P. WATER PIPIN.G/DRAIN-IN WASTE
Installation. Alterations. Re y� ir4versals
J� /
WATER USING DEVICE' -
Ice and/or Coffee maker, hose bib, steamer proofer, carbonator. swamp cooler
11 -
PRIVATE SEWAGE DISPOSAL SYSTEM
WATER HEATER .."^✓"
If Gas. See Mechanical
INDUSTRIAL WASTE PRETREATEMENT
INCEPTORS 1'
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
DCASH 0 CHECK 0 VISA 0 MC
Card#
SIGNATURE
EXPIRES:
VIN
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