2012, 10-30 Permit App: BLD-2012-1969 Plumbing FixturesStaane
,SValley
rearm Lerner
11703 E Sprague Ave, Suite 13-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
permncenter@,spokanevallev.erg
•Community Development
Plumbing Permit Application
SITE ADDRESS:
9// Laciee
PERMIT NUMBER: 4 QA -(2 - (q t
PERMIT FEE: ty 3 o % ,
n Commercial I A'Kesidential
9
❑CASH D CHECK D VISA DMC
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/Bu i lding/Pl umbingPermi tApplication040309. doe
Building Owner
Name: at/_er S6�i7 /__, I/ Phone: 32/, 7 5 Fax:
`.L»y
Address: /�-�, / '�/OCe11TZ„K City: State: �a
4LC
Zip:
Contractor fC,
J�,//' //'
Name: ii p /456,...\_464 Ser �/Lei Phone: 5-299 Fax.
Address: (0/ Box 30/3'7' City: SA State: �l
Zip: C %71233
License No: 4 /_ //]'n 9 At ct 05n -n r� City Ensile -Ss Lie:
`'Y M' (5.//
Contact/Project Manager:
Name: Phone:
# 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
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 D CHECK D VISA DMC
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/Bu i lding/Pl umbingPermi tApplication040309. doe