2015, 04-27 Permit App: BLD-2015-0922 PlumbingCommunity Development
Permit Center
#6;lCITY OF 11703 E Sprague Ave, Suite B-3
le Spokane Valley, WA 99206
,;,110OValley PHONE: (509) 720-5240
FAX: (509) 688-0037
Plumbing Permit Application ❑ Commercial Residential
SITE ADDRESS: I
Project =_s
RECEIVED
P T .
CSV PERMIT CENTER
Building Owner
Name: Ut'l
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Address: 3611 IJ L44-ISPPIL
S- City.'Spp b State:
zip:ggZOS
Contractor
Name:
�� Phone: Fax:
Address:
City: State:
Zip:
License No:Io L
City Business Lic:
Contact/Project Manager.
Name: O Al
Phone: I- ( o
# UNITS
PLUMBING FIXTURE ON A TRAP
TOILETS
URINALS
^
TUBS
SHOWERS(per trap)
I
SINKS
Lav/Basins, Bar, Floor, Kitchen, Laundry, Utility, Janitor, Photo, X-ray, Food,
Prep/Culinary Prep/CulinaryMeat
5
DISHWASHER
CLOTHES WASHER
i
GARBAGE DISPOSAL
i
WATER SOFTNER
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
J
PRIVATE SEWAGE DISPOSAL SYSTEM
WATER HEATER
If Gas See Mechanical
INDUSTRIAL WASTE PRETREATEMENT
INCEPTORS
Including tra , vents except kitchen type grease interce tors 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
Signature
CURRENT FEES AVAILABLE AT: http://www. spokanevalley.orcl/ under the quick links for Forms, Master Fee Schedule.