2014, 10-07 Permit App: BLD-2014-2435 Plumbing ReversalSpoikankan ems'
4ey.
Community Development
Permit Center
11703 E Sprague Ave, Suite 8-3
Spokane Valley, WA 99206
PHONE: (509) 720-5240
FAX: (509) 688-0037
Plumbing Permit Application 0 Commercial RI Residential
SITE ADDRESS: / 7 / y it/
Project w v� r/ d�—I 9'1-1-35/
RECEIVED
OCT 07 2014
PERMIT FEE:
(-;SV PFRNUT
CI IR rr
Building Owner
Name:
Phone: Fax:
Address: City: State: Zip:
Contractor
Phone: c' 7Q 7,„2 Fax
Name: an c
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Address: (e f/'� (�
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License No: City Business Lic:
Contact/Project Manager:
Name: Phone:
# UNITS
PLUMBING FIXTURE ON A TRAP
TOILETS
URINALS
TUBS
SHOWERS (per trap)
SINKS
LavBasins, Bar, Floor, Kitchen, Laundry, Utility, Janitor, Photo, X-ray, Food,
PreplCurinary 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
WATER USING DEVICE
Installation Alterations Repair Reversals
OAK
PRIVATE SEWAGE DISPOSAL SYSTEM
WATER HEATER
Ice and/or Coffee maker, hose blb, steamer proofer, carbonator, swamp cooler
If Gas, See Mechanical
INDUSTRIAL WASTE PRETREATEMENT
INCEPTORS
REPAIR OR ALTERATION
Including traps vents except kitchen type grease interceptors functioning as fixture traps
Water piping drainage or vent piping
ATMOSPHERIC TYPE VACUUM BREAKER
BACK FLOW PROTECTIVE DEVJCE
MEDICAL GAS
INCEPTORS
Signature
Other than atmospheric type vacuum breakers
CURRENT FEES AVAILABLE AT: http:l/www.spokanevallev.oro/ under the quick links for Forms, Master Fee Schedule.