2012, 10-30 Permit App: BLD-2012-1964 Water HeaterSpokan�
�Ualley
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
permiteenter.Thspokanevallev ore
Community Development
Plumbing Permit Application
SITE ADDRESS: _ 2112.1 5 /IOLIK /?
24/2., /y or
PERMIT NUMBER:
PERMIT FEE: «3 QO
❑ Commercial SResidential
'Building Owner .
Name. Phone Fax
3rawn 9.2/8— 76 /,Z
,/
Address: q2/ S /44K � City S;Ozin r [/V re)„ State f/�, Zip `(�Z//
Kr r0
Contractorii - /
Name Phone' Fax.
Spoktrn� 7=u Us �/,ir.,.,l�l� Ss//—�GSo7
p �1
//"U 01 C� City. Spot ....7 a State. 414 Zip c'2/.0
Address ri 2.0 Nt/
qqr
License No SI o !`'/-I F p q�1 i- 2._ City Business Lie. y�6
0�0� J'
Contact/Project Alanager: " - - - -'
...
Name 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 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
�r
/
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
OCASH ❑ CHECK 0 VISA ❑ MC
Card#
SIGNATURE.
EXPIRES
VIN
P \Community Development\02 Administration \03 Forms - Official Versions\Permit Center \Plumbing Permit Application 04-03-09 dg doc