2011, 06-20 Permit App: 11001788 Drain,,,.Valley
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
permitcenterifspokanevaIleyorg
Community Development
Plumbing Permit Application
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PERMIT NUMBER:
PERMIT FEE:
n Commercial jzf Residential
SITE ADDRESS: 76/c E L- 1' r r % /e
Building Owner
Name: /1/(71(`c �K�,2-r slJ� Phone: ? ..3.7,27 Fax
Address: 7 4 ,c4 er'* 4,e City: s 00,4"2@�/i y State: .1,z7/4 Zip: 7°9,2 /.2
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Contractor
Name:./.4.1,.C�1^ Y � / Phone: Fax:
^1��! ( '//fir ��cLc,Yli!h��6- �.?ve>
Address. 7l l Fi 4,,,,7,1-f-,1_ Ave City' - i0O/C/kheW4 c State: V74 Zip: 9 r2l. _
License No: City Btfkiness Lic:
Contact/Project Manager:
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Name: J (A H N 1/2.1.i / e. `, Phone: 02 / 8 "� 33j
# 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
i
FOUNTAIN, DRINKING
WATER PIPING/DRAIN-IN WASTE
Installation, Alterations, Repair, versals 5 e fie- V-
f
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 0 CHECK 0 VISA 0 MC
Card#
SIGNATURE
EXPIRES:
VIN
l :\Community Developmen602 Administration\03 Forms - Official Versions\Permit Center\Plumbing Permit Application 04-03-09 dg.doc