2010, 09-28 Permit App: 10003168 Plumbing FixturesSpolia ems'`
.40;ifValley„
rormiL UMW'
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
permitcenterna,spokanevalley.ot
Community Development
Plumbing Permit Application
PERMIT NUMBER: ( `t)
n Commercial (Residential
SITE ADDRESS: 3 0� D A/ Ar /1(
IPJ
Building Owner
Name: E//xe lei/ MaHme/e,„ Phone: r2'.rR8 7 Fax:
Address: ,2 act /7 far Jr, City:5(04 m e J/ - y State: Zip: g 9� 62
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Contractor s
/��! / L Fax: 722 ,,- FO f O
Name: 4:2_1,-,.17 ,4 / h FxGAv'QT f ✓`may Phone: 9��0G'� �0�
,�, /
Address: 7(/ 7 leu r %eve I city: s>,, re, 1y,t V�C(/Y State: Zip: 79a /o2
License No: �-a r r m e ! 7 sir City Business Lic:
Contact/PrrojectManager: 4j„,„ y Ail/(j /%4//1 0004,6","G
Name: L Ah!^ y r f(C r m& 6' N7 /4',io A C Phone: a?4 J?f r , 7c j__4-7„2_,
# 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
i91
DISHWASHER
CLOTHES WASHER
Pf' rw P $` Xe ver fa (f/ l•tuhP y -7,:t
4/un^p
GARBAGE DISPOSAL
-'e:• r Se we r /loci<ier
WATER SOFTNER
FLOOR DRAIN
Area, Case Coil, Trench Condensate
ROOF DRAIN/OVERFLOW DRAINS
FOUNTAIN, DRINKING
WATER PIPING/DRAIN-IN WASTE
Installation, Alterations, Repair, Bversals — _
WATER USING DEVICE
Ice and/or Coffee maker, hose bib, steamer proofer, carbonator, swamp cooler
1
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 ❑ CHECK ❑ VISA ❑ MC
Card#
SIGNATURE:
EXPIRES:
VIN:
CURRENT FEES AVAILABLE AT: http://www.spokanevalley.orq/ under the quick links for Forms, Master Fee Schedule.
http://www.spokanevalley.org/uploads/Community Development/Documents/Forms/Building/PlumbingPermitApplication040309. doc