2011, 05-23 Permit App: 11001425 Plumbing FixturesSiZialC;\"*`
4000Valley
.
Permit Center
1 1703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
perm itcenter:dspokanevallev. org
Community Development
Plumbing Permit Application
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PERMIT NUMBER:
PERMIT FEE:
Li Commercial 5i4 Residential
SITE ADDRESS: ?41 ! m. Pahl
Building Owner
Name:Phone:
�'anK 'ryjQck 95) -Id?� Fax:
Address: 5a rr,e 41100 C. City.rep UL `/ State: WA Zip: �� 7 j,i.1
Contractor `y
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Name: % Arrpl‘\crXcri-Phone:'1 j i.33 s— Fax: 507. /�f,1_50)
�Address:+^-2i
7A i . t \le_ City: .5p, 0.2yState: (» A. Zip: /-7. r a
License No: City Busirfess Lic:
Contact/Project Manager:
Name: Phone:
# 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
i
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
❑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