2011, 07-06 Permit App: 11001986 Plumbing FixturesBuilding Owner
Permit Center
crn c
®lane
Valley„
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11703 Sprague E
P ague Ave, Suite B-3
Spokane Valley, WA 99206 I
(509)688-0036 FAX: (509)688-0037 r
permitcenterna,spokahevalley.org
i t� � A PERMIT NUMBER:
I I �`r'
1 PERMIT FEE:
Community Development
City: State:
Zip:
Plumbing Permit Application
❑ Commercial Z Residential
SffE ADDRESS: __ 32/15—
42
Phone: a 5— Fax: �A
Building Owner
Name:
Phone: 9 7 Fax:
Address:
City: State:
Zip:
Contractor
LL G
Name: S
Phone: a 5— Fax: �A
Address:
City: State: `✓�
Zip:
License No: 4MM S
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 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
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 pe 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 ❑ CHECK ❑ VISA ❑ MC EXPIRES:
Card# VIN:
SIGNATURE:
CURRENT FEES AVAILABLE AT: http://www.spokanevalley.orq/ under the quick links for Forms, Master Fee Schedule.
http://www.spokanevalley.org/uploads/CommunitypevelopmentIDocumentsIForms/Building/PlumbingPermitApplicationO4O309.doe