2012, 09-07 Permit App: BLD-2012-1521 Plumbing FixturesPermit Center B `A — Z,01 Z 5-,7
11703 E Sprague Ave, Suite B-3 PERMIT NUMBER:
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037 PERMIT FEE: SSS'
venniteenter@sRokanevalley.org
Community Development
1PlumbiIILy Permit
^— STTE ADDRESS: ����� i� iia PV'P/ eE
❑ Commercial
❑CASH ❑ CHECK A El MC EXPIRES: 12-/13
Card# VIN:
SIGNATURE: -44 r
CURRENT FEES AVAILABLE AT: http://www.spokanevaI ley.org/ under the quick links for Forms, Master Fee Schedule.
http://Www.spokanevalley.org/uploadsICommunit)_ evelopmentIDocuments/Forms/BuildingIPlumbingPermitApplicationO4O3O9.doc
Building Owner
Name: /._t
Phone: �GjB f Fax:
Address: 5`
City: G State: �/I Zip:
Contractor
Name:
Phone: Fax:
Address:
City: State: Zip:
License No:
City Business Lic:
Contact/Project Manager:
Name:Y i /
f pOH
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 exce t 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
J
❑CASH ❑ CHECK A El MC EXPIRES: 12-/13
Card# VIN:
SIGNATURE: -44 r
CURRENT FEES AVAILABLE AT: http://www.spokanevaI ley.org/ under the quick links for Forms, Master Fee Schedule.
http://Www.spokanevalley.org/uploadsICommunit)_ evelopmentIDocuments/Forms/BuildingIPlumbingPermitApplicationO4O3O9.doc