2012, 03-16 Permit App: BLD-2012-0171 Water HeaterSpokane
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
permitcenter(spokanevalley.org
Community Development
Plumbing Permit Application
srrE ADDRESS: i 4 2.3 L La cu') i
PERMIT NUMBER: IJ kQ - /2
PERMIT FEE: LI 3 it
❑ Commercial itResidential
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DCASH 0 CHECK 0 VISA 0 MC
Card#
SIGNATURE:
EXPIRES'
VIN:
CURRENT FEES AVAILABLE AT: http://www.spokanevalley.orq/ under the quick links for Forms, Master Fee Schedule.
http://wwwspokanevalley.org/uploads/Community Development/Documents/Forms/Building/PlumbingPermitApplication040309.doe
Building Owner
Name: Jt 1 ioNJ k—1 lte_S P_i Phone(S09)435-G—t"1 3 Fax:
Address: 147_3 O Cats i City:$z„,,„He_ t,t_1
l 2d.G,,. �,(.(�r,t State: y. Zip:��
Contractor )
Name: i6t4' L�a (4171-- CI guts Lke‘ Phoni
$VG, LLL AOR/590.'--17lc r r Fax:
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Address- (Zt- i p
13t.1G1<Ev„ e_ A1/4; ._g___ City:5 r,,....e_ v,4,k e State: (ktU, Zip: `j9{ 2.d !o
License No: ff(GDDD Ncie8Q 3 City Business Lic: l
Contact/Project Manager:
Name: oER21 rlaCL4UC L() Phone:
(65_09 i.S90 -pro l I
-
# 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
ELtc.t l If Gas, See Mechanical
i
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 0 CHECK 0 VISA 0 MC
Card#
SIGNATURE:
EXPIRES'
VIN:
CURRENT FEES AVAILABLE AT: http://www.spokanevalley.orq/ under the quick links for Forms, Master Fee Schedule.
http://wwwspokanevalley.org/uploads/Community Development/Documents/Forms/Building/PlumbingPermitApplication040309.doe