2011, 08-12 Permit App: 11002426 Plumbing FixturesS ok n e\°'.'
.jValley
Permit tenter
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
permitcenteraspokanevalley. org
Community Development
m.Plumbing Permit Application
W
SITE ADDRESS: ( /Or / l ` y Fe(
PERMIT NUMBER: -- 7j -f
PERMIT FEE:(53
n Commercial 1 I Residential
Building Owner
Name: J4v i , 1 h Phone: Fax:
Address: 42/ I 1'` C//t� /% City: `� �./ ._ State: ZipZOZ-yo,
/�" `
Contractor N r
7 Fax:
Name: `` a Phone: 7 0
77z
Address: I 1�S"� if,,, 1c'tn it,,, City: /7r.7 . State: , Zip: �3a-3
License No: Mp _,� i Q St i 14 City Business Lic:
Contactt!Project Manager:
Name: a ,4 LL11 ti i ✓.I t• -i 5 Phone: r' G c, - tri % - &' 0 / 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
71
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
DCASH ❑ CHECK ❑ VISA ❑ MC
Card#
SIGNATURE:
EXPIRES:
VIN:
CURRENT FEES AVAILABLE AT: http://www.spokanevalley.orq/ under the quick links for Forms, Master Fee Schedule.
http://www.spokanevalley.org/uploads/Community_Development/Documents/Forms/Building/PlumbingPermitApplication040309. doc
SO
lane
.00eyr
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
permitcenter(aa,spokanevalley. orp
Community Development
Plumbing Permit Application
SITE ADDRESS: Z
PERMIT NUMBER:
PERMIT FEE:
n Commercial Residential
Building Owner
Name: ,7.- %"t / r /, _ r--/� J J Phone: Fax:
Address: 7 3 L fit, %f r i,, J City: ci ems,,-- 7- State: r Zip: 51,4- v
Contractor
Name: Phone: ` _ ? 7/ Fax:
�� l� i7v��-r�- � �vE-�6. JX � —;d:
Address: 'r J 3 G ,7 City: f�7�Y c :,‘ State: _22 Zip: 9,s, i' 5.) _
License No: City Business Lic:
Contact/Project Manager:
Name: �' 4011 11,3(114H% , Phone: 20 k - 5{%, ` -'') J
# 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
,V Qf f 4 Installation, Alterations, Repair, Reversals
Z
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 ❑ VISA ❑ MC
Card#
SIGNATURE:
EXPIRES:
VIN:
CURRENT FEES AVAILABLE AT: http://www.spokanevalley.orq/ under the quick links for Forms, Master Fee Schedule.
http://www.spokanevalley.org/uploads/Community_Development/Documents/Forms/Building/PlumbingPermitApplication040309.doc