2011, 09-19 Permit App: 11002954 Drain ConnectPermit Center
11703 E Sprague Ave, Suite 13-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
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Community Development
Plumbing Permit Application
PERMIT NUMBER: 115L
PERMIT FEE:
111 Commercial ❑� Residential
SITE ADDRESS: 1004 S. Marigold St, Spokane Valley, WA 99037-8616
Building Owner
Name. Peplinski, Kenneth 8 Phone. .
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Address. / Do (i S / r la-, q o 41 s4 City C� /./ff State. Z-ip.9.y7
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Contractor hvo ,vF_ ✓✓„I
Name. Phone: Fax
Address: City: State' Zip
License No City Business Lit
Contact/Project Manager:
Name. Peplinski, Kenneth & Barbara 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
WATERSOFTNER
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 future taps
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 ❑ CHECK 0 VISA ❑ MC EXPIRES:
Card# VIN:
SIGNATURE:
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