2011, 07-20 Permit App: 11002151 Plumbinga
+j` I
Permit Center
ns 11703 E Sprague Ave, Suite B-3 PERMIT NUMBER:
Spokane Valley, WA 99206
1 (509)688-0036 FAX: (509)688-0037 PERMIT FEE:
perm iteenter@spokaneval lev. ore
Community Development
Plumbing Permit Application ❑ Commercial ❑ Residential
SITE ADDRESS:3 2 I I h% • ; Ceram G , 5& oket �.v� GyL�gt 1 v2
Building Owner
Name: YVLOle& �rcSltf
Phone: �—Fb --4172 Fax:
Address: 3 -11
City: S' d State: elt-)A Zip:
Contractor v
Name:
Phone: Fax:
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 tra
SINKS
Lav/Basins, Bar, Floor, Kitchen, Laundry, Utility, Janitor, Photo, X-ray, Food,
Prep/Culinary Prep/CulinaryMeat
DISHWASHER
CLOTHES WASHER
GARBAGE DISPOSAL
WATER SOFTNER
FLOOR DRAIN
Area, Case, Coil, Trench, Condensate
ROOF DRAIN/OVERFLOW DRAINS
FOUNTAIN, DRINKING
WATER PIPING/DRAIN-IN WASTE
Installation, Alterations, Repair, Reversals
i
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
JR V L U.,
❑CASH ❑ CHECK ❑ VISA ❑ MC EXPIRES:
Card# VIN:
SIGNATURE:
P:\Community Development\02 Administration\03 Forms - Official Versions\Permit Center\Plumbing Permit Application 04-03-09 dg.doc