2011, 03-28 Permit App: 11000717 Water PipingkC
Permit Center
11703 E Sprague Ave, Suite 13-3
Spokane Valley \VA 99206
(509)688-0036 hAX (509)688-0037
pennitcenter<+spokanevallec ore
Community Development
Plumbing Permit Application
//-0'2/9
PERMIT NUMBER:
PERMIT FEE:
❑ Commercial I:R.-Residential
srrEADDKESS: of7. 14.023 At C1 »— e
Building Owner Sc—c 7 /lac ka y
Name C/4.2 0Q fret YE$otL) Phone Fav'
CIO/
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Address .x.4/7 N C Qw„ter/ Cuv S�0/�Q he Kay State W Zip / //V 4oZ
Contractor
/ '/ 1
E c41/AI 14.4 Phone 9'/%'/0200 Fav 9a�-r /0
Name Larr A' 1L r
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r/p(er.
Address' / / 1 L /l L('&'e'r Aye l Cmv /i/e°OI6QhCAa2 y State. Woof Zip 9982 /a
License No I ftiR gy/146,7/gpR City Business Lie Cox toa 970
` / •I G. 1 O r \ O
Contact/Project Manager:
Name j# -t- r7 »q ((`r Phone l 8 — 33 3 r
# 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
WATER SOFTNER
FLOOR DRAIN
Area. Case, Coil, Trench, Condensate
ROOF DRAIN/OVERFLOW DRAINS
FOUNTAIN, DRINKING
0` WATER PIPING/DRAIN-IN WASTEInstallation,
Alterations, Repair, Reversals"!'. -we r Nccrup
/
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 atmosphenc type vacuum breakers
MEDICAL GAS
INCEPTORS
OCASH O CHECK 0 VISA 0 MC
Card#
SIGNATURE:
EXPIRES
VIN
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