2011, 06-13 Permit App: 11001704 Drain Connectrr" kantttttt�
Community Development
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX- (509)688-0037
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Plumbing Permit Application
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PERMIT NUMBER:
PERMTI- FEE:
❑ Commercial
esidential
SITE ADDRESS:
71-07 E Arrns±yorner y Ave
Building Owner
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Name Phone y0 _ 4-,q 70 Jar 71C-193-3 4 /
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Address .7li- o 7 .p /rZp i, 1-"`ry City: State. 1 Zip.
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Contractor
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Name. Phone Fax: /
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Address' 7 1 / 7 1,,,:_--. /t- 'f G N /lee City. 5/9n4 h C Y e,, State. ye Zip: / 9 r /.Z
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License No City Business Lic:
Contact/Project Manager: Lott.,,, �/%%r
Name / Phone: 2 i 5 -37 f5—
# OF UNITS
PLUMBING FIXTURE ON A TRAP
TOILETS
URINALS
TUBS
SHOWERS (per trap)
SINKS
Lav/Basms, 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
c
Installation, Alterations, Repa(r, Reversals .5eWer
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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
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Other than atmospheric type vacuum breakers
MEDICAL GAS
INCEPTORS
❑CASH 0 CHECK 0 VISA 0 MC
Card#
SIGNATURE:
EXPIRES:
VIN:
P:\Community Development \02 Administration \03 Forms - Official Versions\Permit Center\ Plumbing Permit Application 04-03-09 dg doc