2013, 10-03 Permit App: BLD-2013-2031 Plumbing Fixtures10/E-2/2013 20:5
ISpocirulane
9 5099288998
Permit Center
1 [703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)683-0036 FAX (509)688-00
PSI:UtilReliterg.spoltanevnlIrv.org
Community Development
Plumbing Permit A plication
SITE ADDRESS:
.`D.9 E
UNITED PLUMBING
CO
PAGt w.I G1
PBRMIT NUMBER:
PERMIT IZEE:
9-0
esidential
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aullala$&Oiler
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Nume: �j w�-� ,,�� __ Phone: �] 'p " l Fax- 7 dAO
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is
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" State.
Address: P., . city: A}4
Contractor' ,/�
,1 T1s /t�—• •`•'. :..:•;';::
Phone: 5.7)0 ou,:
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p. �,°�4(lt
" Name:
A � Lave"— City: State.
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Address: p I1 J
License No: 17Z.itZ-
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gr* '*.. .1 City Busin • s Lie:
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Contait/Prdje'vt xnagee.' •,• ;.r.': • •
Name: dir "" Phone: 3 "/ /6'
# OF UNITS
FIXTURE ON A TRAP
PLUMBING
TOILETS
it
2'
URINALS
TUBS
4
SHOWERS (per trap)
_ , •
LavBasIns, Bar, Floor, Kitchen, Laundry, Utility, Janitor, Photo, X-ray, Food,
Pre•)Cuiina Meat
SINKS 1
•
DISHWASHER
CLOTHES WASHER
{,r
' /
' ' v ✓ 3
GARBAGE DISPOSAL
etA^
WATER SOFTNER
FLOOR DRAIN
Area, Case, Coll, Trench, Condensate
,
ROOF DRAIN/OVERFLOW DRAINS
FOUNTAIN, DRINKING
WATER PIPING/DRAIN-IN WASTE
Installation, Alterations, Repair, Reversals f
Ice and/or Coffee maker, hose bib, steamer proofer, carbanator, swamp cooler 1
WATER USING DEVICE
PRIVATE SEWAGE DISPOSAL SYSTEM
WATER HEATER
If Gas See Mechanical
INDUS I FtIAL WASTE PRETREATEMENT
INCEPTORS
Including traps, vents except kitchen pa grease Interceptors functioning as fixture traps
REPAIR OR ALTERATION
Water 2i�np, drainage or vont piping
Other than atmospheric type vacuum breakers
ATMOSPHERIC TYPE VACUUM BREAKER
BACK FLOW PROTECTIVE DEVICE
MEDICAL GAS
INCEPTORSry
�y p�j
"i (SIJ
-t___..________.3°1 3
421
❑CASH 0 CHECK Ed VISA ❑ MC
Card#
SIGNATURE:
REDACTED
EXPIRES:
IN:
•
REDACTtL
This document originally contained
confidential credit card information which
was redacted pursuant to RCW 19.255.010
and the original document destroyed
pursuant to 505 DAN G52014-030.
CURRENT FEES AVAILABLE AT: hst¢ wwvis_ aangvalley,ozg( under the quick links for Forms, Master Fee Schedule.
http://www,spokanevallcy.orgtuploadsiCommunity Development/Documents/Forms/Building/PlumbingPermitApplieation040309.doe
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