2013, 02-27 Permit App: BLD-2013-0300 Plumbing FixturesSpo°rka eL
4'es
rermit tenter
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
pennitcenter@spokanevalley.org
Community Development
Plumbing Permit Application
SITE ADDRESS: W Z) Aj , L % L -L y
PERMIT NUMBER:
PERMIT FEE:
❑ Commercial yi Residential
LICASH ❑ 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/FormsBuilding/PlumbingPennitApplication040309. doc
Building Owner
Name: Phone: Fax:
Address: ".00.8 , Lrzil.City: State: Zip:
Contractor
Name: Ce_e_ fl irS i e -.4-r.; co ,,t s -(, Phone: Fax:
Address: City: State: Zip:
License No: 2_C D E Dc_ 8g ( p l� F City Business Lic:
v c/
Contact/Project Manager:
Name: Phone:
# OF UNITS
PLUMBING FIXTURE ON A TRAP
TOILETS
URINALS
TUBS
tj
N
SHOWERS (per trap)
SINKS
Lav/Basins, ar, 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
P re A -lo If Gas, See Mechanical
INDUSTRIAL WASTE PRETREATEMENT
INCEPTORS
Including traps, vents except kitchen type grease interceptors functioning as fixture traps
REPAIR OR ALTERATION
7 Water piping, drainage or vent piping
ATMOSPHERIC TYPE VACUUM BREAKER
BACK FLOW PROTECTIVE DEVICE
Other than atmospheric type vacuum breakers
MEDICAL GAS
INCEPTORS
LICASH ❑ 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/FormsBuilding/PlumbingPennitApplication040309. doc