2011, 08-04 Permit App: 11002327 Plumbing Fixtures4000 Valley
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
perm itcenter(a) snokaneva l l ev. org
Community Development
Plumbing Permit Application
PERMIT NUMBER: \ 4'321
PERMIT FEE:
❑ CommercialResidential
SITE ADDRESS: 3 /0,2. N.: + f^ (
Building Owner,���
Name: Jrf4r A f�mrw Phone: „5"7O - CZ..iZ3 Fax:
4
Address: 3 ( t, / r 4 ,� 6y City: Spe, K`i� State: K%A- Zip: I( "/2
Contractor r
Phone: 9:24, `_./a0C� Fax:
Name: Z Gi r h y Ai; ((e..),-p
�,c��CAvGG�r,
Address: 7 ( 7 r , [ l 1,'L < l e- %e' AKee City: 50,0 ���e ' State: Zip:9f /
License No: City Busi ess Lic: c
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Contact/Project Manager: / a N r' ! ((E Y
Name: ( Phone: 2/ 8 P f 3 3
# 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
e
FOUNTAIN, DRINKING
WATER PIPING/DRAIN-IN WASTE
_ C
Installation, Alterations, Repair eversals� Sekre "
1
WATER USING DEVICE
Ice and/or Coffee maker, hose tib, 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
OCASH 0 CHECK 0 VISA 0 MC
Cara#
SIGNATURE
EXPIRES
VIN
r':\Community Development\02 Administration\03 Forms - Official Versions\Permit Center\Plumbing Permit Application 04-03-09 dg.doc