2011, 08-01 Permit App: 11002279 DrainSpokane
• cOValley.
Permit Center
11703 E Sprague Ave, Suite 13-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
permiteenter(a)spokanevalley org
Community Development
_ Plumbing Permit Application•
SITE ADDRESS: /y 7// Free&/ (fL
PERMIT NUMBER: f (� 9Q-167
PERMIT FEE: Q y
❑ Commercial
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Residential
Building Owner
Name Phone: Fax:
Address: City: State: Zip:
NamesContractor
rc A Gq, h e Phone: 02 C/ —S V O p S Fax
Address 7 9 S / „,-4,C- 5tic City: G eez„, .[ C re _S
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l7 g L1/ State: ��✓, Zip: / �(O
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License No: 6 U City Business Lie.
Contact/Project Manager:ag�
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Name) /r S -e ( , LI ✓'Gl�Gt
i:o R Phone: 9 a 7-2 — � ger/2.
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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, drainage or vent piping
ATMOSPHERIC TYPE VACUUM BREAKER
BACK FLOW PROTECTIVE DEVICE
Other than atmospheric type vacuum breakers
MEDICAL GAS
INCEPTORS
❑CASH ❑ CHECK 0 VISA ❑ MC EXPIRES:
Card# - VIN:
SIGNATURE:
CURRENT FEES AVAILABLE AT: http.//www.spokanevalley orq/ under the quick links for Forms, Master Fee Schedule.
http.//wwwspokaneval ley.org/uploads/Community_Development/Documents/Forms/But Iding/Plumb ingPenmtApplicatwn040309.doc
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