2013, 04-18 Permit App: BLD-2013-0683 Plumbing FixturesPermit Centex
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX (509)688-0037
peonitcenter@spokanevallev.org
Community Development
Plumbing Permit Application
PERMIT NUMBER:
PERMIT FEE:
❑ Commercial gResidential
SITE ADDRESS: / % q t� %C. E , or, 77 OA ye
❑CASH ❑ CHECK ❑ VISA ❑ MC
Card#
SIGNATURE:
EXPIRES:
VIN:
APR F 3
CSV �r?`
:7: ENTER
CURRENT FEES AVAILABLE AT: http://www.spokanevallev.orq/ under the quick links for Forms, Master Fee Schedule.
Building Owner
Name: X r(kr;,,,A U A.. ),yam - Phone: if ei, 3_ f r al O Fax:
Address: fC- K� e City: S e, Kt j/ rL x State: pe /,q Zip: / re,/ 6,
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Contractor
Name: Lary , Cr Ex/icva't"1 hg Phone: €r14..
ia Fax (IAA '5Og0
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Address: 7117 El R -ec A Ve City: . Y sate: wA Zip: iciA i4
License No: LARRY 1111E 91 tf D R City Bush Lie:
Contact/Project Manager:
Name: Lac, rvadj. C r Phone: a i (. 3335
# 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, Cod, Trench, Condensate
ROOF DRAIN/OVERFLOW DRAINS
FOUNTAIN, DRINKING
Pr" WATER PIPING/DRAIN-IN WASTE
457/49.arGt I iNnstallation, Alterations, Repair, Reversals $ e Wt r
/
WATER USING DEVICE
Ice and/or Coffee maker, hose bib, steamer [rimier, carbonator, swamp cooler
PRIVATE SEWAGE DISPOSAL SYSTEM
WATER HEATER
If Gas, See Mechanical
INDUSTRIAL WASTE PRETREATEMENT
INCEPTORS
Including traps, vents except kitchen type lease 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
Pro;Lct B._ 63
❑CASH ❑ CHECK ❑ VISA ❑ MC
Card#
SIGNATURE:
EXPIRES:
VIN:
APR F 3
CSV �r?`
:7: ENTER
CURRENT FEES AVAILABLE AT: http://www.spokanevallev.orq/ under the quick links for Forms, Master Fee Schedule.