2014, 01-02 Permit App: BLD-2014-004 Plumbing FixturesCommunity Development
Permit Center
Wiliam 11703 E Sprague Ave, Suite 8-3
`�'7 Spokane Valley, WA 99206
V[dlley` PHONE: (509) 720-5240
FAX: (509) 688-0037
TAA Cas `Hipp
SLD -a1011-COO
Plumbing Permit Application 0 Commercial 0 Residential
SITE ADDRESS:
PERMIT FEE:
Building Owner fl) Q Nk,R. On F -E/1 1.
Name: Phone: / Fax:
�%S
Y1 ,r7 C/
Address: € 9 7 / ti V Q �'f T e �) City: %l /-' V 5Eu2 State: i O Zip: S /
Contractor f 1..L.-... 5 -t9 JV S' /p L V m d7 A/4' L -GS
Name: Phone: 2 / % _6024 Fax:
I�
Address: j (2 2n i -7_ of V 1: City: .�'pc' dold—el State: fir/' At Zip: 7 9 co /L
License No: ft K 5 � f /1, o r0 3 /J D City Business Lic:
Contact/Project Manager:
Name: Phone:
# UNITS
PLUMBING FIXTURE ON ATRAP
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 .
DRAIN
Area, Case Coil Trench, Condensate
FLOOR
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 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
Signature
3 JJ��� hVVh 0(3 CL
CURRENT FEES AVAILABLE AT: http://www.spokanevallev.orcd under the quick links for.Fo s, MSster.Fee Schedule.
t3tUtivtU
JAN 02 2014
CSV PERMIT CENTER
SUB#I I REV.#