2014, 08-22 Permit App: BLD-2014-2016 Plumbing ReversalSpokane
® $ Va11eyt
Community Development
Permit Center
11703 E Sprague Ave, Suite B -
Spokane Valley, WA 99206
PHONE: (509) 720-5240
FAX: (509) 688-0037
Project # --(_±.:42)S,
RECEIVED
AUG 2014
Plumbing Permit Application ❑ Commercial [Residential.etr n _ _
SITE ADDRESS:
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Building Owner
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Name: L.3' 0. � [ \l o -c V 1 S Phone: ZZA 25 (es 3 Fax:
Address: S25 E IftflQI✓� City: &J 11� State: 01/4) L1 Zip: G�C�Zl2
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Contractor
Name: Phone: Z2D Fgas 3 Fax:
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Address: ?j 3b2, 74 i �-l-is
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License No: n t.0est -{tee, t-) City Busing s Lic:
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Contact/Project Manager:
Name: Phone:
# 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
j
1
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
Signature u3
CURRENT FEES AVAILABLE AT: http://www.spokanevalley.orq/ under the quick links for Forms, Master Fee Schedule.