2011, 09-26 Permit App: 11003020 Plumbing Fixturesan�r'1_Y�
,000Valley,
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
permitcenter4 spokanevalley.org
Community Development
Plumbing Permit Application �
SITE ADDRESS: 3 �% / 5 Ark /roe
PERMIT NUMBER: 1 I —aN)2,01
PERMIT FEE:
❑ Commercial 1tesidential
Budding Owner
Name: Phone: Fax:
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Address: 3 O t S / x '40.01 AW City: 5�e, x frC - State: t�� Zip:
Contractor
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Name: e— {. V:7 ,; f l C . � CrVit7Lt /", Phone: IaZ to ,/,200 Fax: lfa,2 , 5"O ( e,
Address: 7 I ( c- X w7� A Ye City: S�v V /7e cj State: WA Zip: fr,z (A
,, License No: City Business Lic:
Contact/Project Manager:
Name: /eky, j„N //trek -Phone: „2 / 4D 3335
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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
e
FOUNTAIN, DRINKING
Installation, Alterations, Repair, Reversals i/rri 12rciir- (
ith /
''''''' WATER PIPING/DRAIN-IN WASTE
WATER USING DEVICE
Ice and/or Coffee maker, hose bib, steamer proofer, carbonator, swamp cooter
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
r:\Community Development \02 Administration\03 Fonns - Official Versions\Permit Center\Plumbing Permit Application 04-03-09 dg.doc