2013, 10-10 Permit App: BLD-2013-2090 Sewer, Back Flow DeviceSpo�kankane�
.00015Valley.
Plumbing Permit Application
Community Development
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
PHONE: (509) 720-5240
FAX: (509) 688-0037
PERMIT NUMBER:
PERMIT FEE:
0 Commercial ❑ Residential
SITE ADDRESS:
Building Owner 27244 1410m,&? -/to
Name: Phone:
FFax:
Address: /',kY /�/7 ivie..icLt c CItytiVSGD/. r¢ /ill STtate: eil4 0�7 Zip:
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Contractor ..-7}.-Cs- kr/_CJA 0:2;d6.-
7J-�6
Name: 5,, �G1i��7, Phone: Fax:
Name:
Address: 3995 A74v 4 City: r-',24),-.:4-zs7,44. State: e.,,,,,A_ Zip:Y��7
License No: City Business Lic:
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
m"Jj
DISHWASHER
Cet
� I
I 'l -�hqc�
(Vl
CLOTHES WASHER
1 HEC:
FIvr.N
GARBAGE DISPOSAL
1
V
1
# WATER SOFTNER
�+T
1 GI.! 1
0 One 1
34_____
FLOOR DRAIN
Area, Case, Coil, Trench, Condensate
r vlJ i
ROOF DRAIN/OVERFLOW DRAINS
1 LSV PERn
;yr r.-.,__ I
FOUNTAIN, DRINKING
1
r t ch
S 110 t /
d— WATER PIPING/DRAIN-IN WASTE
Installation, Alterations, Repair, Reversals_ / j I
REV f— i 1
----'--- ""I 1
!r WATER USING DEVICE
Ice and/or Coffee maker, hose bib, steamer proofer, carbonator, swamp co ler
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
t
ATMOSPHERIC TYPE VACUUM BREAKER
BACK FLOW PROTECTIVE DEVICE
Other than atmospheric type vacuum breakers
I
MEDICAL GAS
INCEPTORS
Signature
CURRENT FEES AVAILABLE AT: http://www.spokanevatley.orq/ under the quick links for Forms, Master Fee Schedule.
http://www.spokanevalley.org/filestorage/l24/9382101948/14962743/Plumb_App.doc