2011, 07-21 Permit App: 1100212 Plumbing FixturesIJcmV11C1n�
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Community Development
Plumbing Permit Application
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
permitcenter@spokanevallev.org
PERMIT NUMBER: -2,1 7
PERMIT FEE:
n Commercial n Residential
SITE ADDRESS:
Building Owner .. '
Name: Phone: Fax:
Address: 1 City: State: Zip:
Contractor
Name: �t�, ,� Cn�2.v,�-„,,� (7r m b V � �) Phone: � vi - sir & s Fax:
Address: , 04) & € q”` AGUE City: State: Zip:
License No: City Business Lic:
Contact/Project Manager:
Name: sayltii...Phone: 1 2 N ^ 5-y &
# OF UNITS
PLUMBING FIXTURE ON A TRAP
TOILETS i
URINALS i'
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 1.
FLOOR DRAIN
Area, Case, Coil, Trench, Condensate
ROOF DRAIN/OVERFLOW DRAINS
FOUNTAIN, DRINKING i
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 ;i.
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
i
ATMOSPHERIC TYPE VACUUM BREAKER
BACK FLOW PROTECTIVE DEVICE "
Other than atmospheric type vacuum breakers
MEDICAL GAS
INCEPTORS
r
!]CASH 1:1CHECK 1:1VISA ❑ MC
Card#
SIGNATURE:
EXPIRES:
VIN:
CURRENT FEES AVAILABLE AT: http://www.spokanevalley.orq/ under the quick links for Forms, Master Fee Schedule.
http://www.spokanevalley.org/uploads/CoMmunity Development/Documents/Forms/Building/Plumb ingPermitApplication040309. doe