2012, 05-18 Permit App: BLD-2012-0672Spokane
galley
11703 E Sprague Ave, Suite 13-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
permitcenter(7a,spokanevalley. ory
Cosinumty Development
Plumbing Permit Application
SITE ADDRESS: / 3 2- e /76-77,9, /1'✓C,
PERMIT NUMBER: MI, (Z. 67Z
PERMIT FEE: ,� 9/ 3 o
Fl Commercial n Residential
Building Owner
Name: yzA cbLu at cr I%&s
Phone:
Fax:
Address: v
3 3 1/4614_0(7)City:
5/0/emrLE IJ/l.Lfl`rj+
State:
4.4,,e7
Zip:
cA Q Z/
6
Contractor
Name: b. C01,c2e(,W n/F
Phone: CJ Z Ysvef'
Fax:
Address /13d y/7 C• S Pn,4-6 a_e
CrtY: (7K& //Cut&S
State:
G --int—
Zip:
'3', p/
6
License No:
City Business Lic:
Contact/Project Manager:
Name) /,h 66026F
r
Phone: 4,s C' 7/5 7,-
PLUMBING FIXTURE ON A TRAP
# OF UNITS
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 Coll, Trench, Condensate
ROOF DRAIN/OVERFLOW DRAINS
FOUNTAIN, DRINKING
WATER PIPING/DRAIN-IN WASTE
Installation, Alterations, Repair, Reversals
WATER USING DEVICE
PRIVATE SEWAGE DISPOSAL SYSTEM
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
Including traps, vents except kitchen type grease interceptors functioning as fixture traps
Water piping, drainage 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//wiwv.spokanevallev.orq/ under the quick links for Forms, Master Fee Schedule.
http://wwwspokanevalley.org/uploads/Community Development/Documents/Fors/Building/PlumbingPerrnitApplication040309.riot