2011, 10-21 Permit App: 11003357 Plumbing Fixtures*Wane
.0.0Valley
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
perirmsen L;jAp.gkaney_alle Lorg
Community Development
Plumbing Permit Application
SITEADDRES!. 1.,60;\ AL PLC) RA ROAD
PERMIT NUMBER: l' ' 333-7
PERMIT FEE:
21 Commercial (1 Residential
SPDKAk)E vALL,EY 1,JA 9q2.14.
Building Owner Cl ry OF S PDKA ju E UALLL-Y
Name: �(� 0 () I
SAME Phone: �1a QL7 r..?„_,_,
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Address: i I -76.7 /:. cPRA410_ Aof_ City: —.!�/
*4, Stute: / ��
Contractor TM8ER Afl LAAJDSLAPING 4 a *C1crialerlyl) riuG
Name: /7.44 �jgLTMAiJ Phone:
y'9�`An,2 S r•a.:
Address: n n. & /I A34
License No: nma EL c gigs K p
Contact/Project Manager:
lip: 99Zdt
City: PAKAAxe State: /41/9
City Business Lic: 602 2 S 7 - A39
Name: r Ait /Abu r
!1 Phone: 37U
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PLUMBING FIXTURE ON A TRAP
TOILETS
# OF UNITS
URINALS
TUBS
SHOWERS (per trap)
SINKS
DISHWASHER
Lav/Basins, Bar, Floor, Kitchen, Laundry, Utility, Janitor, Photo, X-ray, Food,
Prep/Culinary Meat
CLOTHES WASHER
GARBAGE DISPOSAL
WATER SOFTNER
FLOOR DRAIN
ROOF DRAIN/OVERFLOW DRAINS
Area, Case, Coil, Trench, Condensate
FOUNTAIN, DRINKING
WATER PIPING/DRAIN-IN WASTE
WATER USING DEVICE
PRIVATE SEWAGE DISPOSAL SYSTEM
Installation, Alterations, Repair, Reversals
Ice and/or Coffee maker, hose bib, steamer proofer, carbonator, swamp cooler
WATER HEATER
INDUSTRIAL WASTE PRETREATEMENT
INCEPTORS
If Gas, See Mechanical
REPAIR OR ALTERATION
ATMOSPHERIC TYPE VACUUM BREAKER
BACK FLOW PROTECTIVE DEVICE
MEDICAL GAS
Including traps, vents except kitchen type grease interceptors functioning as fixture traps
Water piping, drainage or vent piping
[16&10 50 50 Davi f Cti CK
Other than atmospheric type vacuum breakers
'1
INCEPTORS
❑CASH 0 CHECK I] VISA 0 MC
Card#
SIGNATURE:
EXPIRES:
VIN:
P:\Community Development\02 Administration\03 Forms - Official Versions\Permit Center\Plumbing Permit Application 04-03-09 dg.doc