2010, 09-23 Permit App: 10003043 Sewer Reversalvalley.
Permit Center
11703 E Sprague Ave, Suite 13-3
Spokane Valley, WA 99206
(509)688-0036 FAX. (509)688-0037
.ermitcente es.okanevalle or•
Community Development
Plumbing Permit Application
sl'rE ADDRESS: / 2- 2 0
PERMIT NUMBER: f 0 — 3 eNs
PERMIT FEE:
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Building Owner . -
. Phone: Fax
Name -404-14
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Contractor �� I
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Name: T' /J I Phone: Fax.
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Address: L-r1�1
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License No: City Bus n{ness
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Contact/Project Manager:1
Name: off y /C,te. C-- Phone: '3 7l 9 > % / S'—
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# 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 Meat
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 type grease interceptors functioning as fixture traps
REPAIR OR ALTERATION
Water piping, drai nage or vent piping
ATMOSPHERIC TYPE VACUUM BREAKER
BACK FLOW PROTECTIVE DEVICE
Other than atmospheric type vacuum breakers
MEDICAL GAS
INCEPTORS
❑CASH 0 CHECK 0 VISA 0 MC
Card#
SIGNATURE:
EXPIRES:
VIN:
CURRENT FEES AVAILABLE AT: http'//www spokanevalley orq/ under the quick links for Forrns, Master Fee Schedule.
http://wwwspokanevalley.org/uploads/Commundy_Devclopment/Documents/Forms/Building/PlumhingPermitApphcation040309 doe