2011, 04-25 Permit App: 11001032 Water Piping01
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Community Development
Plumbing Permit
SITE ADDRESS:
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
permitcenter(dspokanevallev.org
PERMIT NUMBER:
PERMIT FEE:
❑ Commercial
Building Owner
Name: `
Phone: - Fax:
Address: ' ^ I
City: - o Stater
Zip:
Contractor
Name: i ` PICYA" . �
Phone: Z y,. / 620 Fax:
Address:
City: State:
Zip: 17 f
License No: �. E el r
K City Business Lic: �?� . as
Contact/Project Manager:
Name: ` p� `'' e
Phone: �' g 3"'
# OF UNITS
PLUMBING FIXTURE ON A TRAP
TOILETS
URINALS
TUBS
SHOWERS r 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, Re air, -versals 3 �=
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, drains a or vent i in
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:
P:\Community Development\02 Administmtion\03 Forms - Official Versions\Permit Center\Plumbing Permit Application 04-03-09 de.doc