2012, 08-21 Permit App: BLD-2012-1374 Piping'Spokane
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Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX- (509)688-0037
permmcenter(ospokanevallev. org
Community Development
Plumbing Permit Application
SITE ADDRESS: /CJ 5o5 5/A/f 570."
PERMIT NUMBER: �jki -/Z-IS
PERMIT FEE: CI ?0 <
n Commercial Residential
7/f
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Card#
SIGNATURE:
EXPIRES:
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CURRENT FEES AVAILABLE AT: http://v✓ww.spokanevalley.orq/ under the quick links for Forms, Master Fee Schedule.
http:/hvwwspokanevalley.org/uploads/Community_Development/Documents/Forms/Qui Iding/PlumbingPermitApplication040309.doc
Building Owner
Name:I) �� .A/I Phone: Fax:
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Address: id .s- es r /v// r / 0h City e°AAA? !/i eey State: �Q
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Zip: 99671
Contractor
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Name: C.OIJ✓ C "rA / n.,Q Phonec2 circa s. v &lc-. Fax:
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Contact/Project Manager:
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# 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
FOUNTAIN, DRINKING
WATER PIPING/DRAIN-IN WASTE
Installation, Alterations, Repair, Reversals
1
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
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❑CASH ❑ CHECK D VISA gMC
Card#
SIGNATURE:
EXPIRES:
V
CURRENT FEES AVAILABLE AT: http://v✓ww.spokanevalley.orq/ under the quick links for Forms, Master Fee Schedule.
http:/hvwwspokanevalley.org/uploads/Community_Development/Documents/Forms/Qui Iding/PlumbingPermitApplication040309.doc