2012, 09-24 Permit App: BLD-2012-1652 Sewer, DrainPermit Center
11703 ESpmgue Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
Penniteenterlsookanetallev org
PERMIT NUMBER: eld -I z -t6
PERMIT FEE: Li 3 �9 ,e'
Community Development
Plumbing Permit Application G �//❑ Commercial T Residential
SITEADDRESs
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Building Owner
Name: Phone: Fox:
955,-`j�(,9
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Address: 34o9N. Wcg W OOq City: sPo. U1/2,State: UA Zip:
Contractor /
Name: / ` Phone: G,a c` I) 722 —chit0
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Address: 7 / / C /Ota e r Ave J City: S`,o�e (� (C y State: V/4 Zip: / I ye is .
License No: City Business Lic: /
Contact/Project/Manager. _—�_ - _
Name: tar r y A 1 / ��er Phone: 1' / �`- J3s-1-
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# OF UNITS
PLUMBING FIXTURE ON A TRAP
TOILETS
URINALS
TUBS
SHOWERS (per trap)
SINKS
Lev/Basins. Bar. Floor. Kitchen. Laundry. Ulfty. Janitor, Plato, X-ray. Food.
Prep/Caanary Meat
DISHWASHER
CLOTHES WASHER
GARBAGE DISPOSAL
WATER SOFTNER
FLOOR DRAIN
Area Case. Cod. Trench. Condensate
ROOF DRAIN/OVERFLOW DRAINS
FOUNTAIN. DRINKING
n
WATER PIPING/DRAIN-IN WASTE
/�n Installation, Alterations. Repair. Reversals ((61- L/.0,1.
5/4 %Gt/%v 6
WATER USING DEVICE
Ice and/or Coffee winker. hose tib. steamer woofer. arbonator. 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
Wader piping. drainage or vent piping
ATMOSPHERIC TYPE VACUUM BREAKER
BACK FLOW PROTECTNE DEVICE
-•
Other than atmospheric type vacuum breakers
MEDICAL GAS
INCEPTORS
OCASH O CHECK O VISA OMC
Card#
SIGNATURE
EXPIRES:
VIN
2:1Community DcvelopmenA02 Administmtionl 3 Forms - Official VersionsWtmlit Centet\Plumbing Permit Application 04-03-09 dg.doc