2010, 11-08 Permit App: 10003727 Plumbing FixturesSpokes e®
..;IIIIIIIII11OValley
Community Development
Plumbine Permit
SITE ADDRESS:
rcrmi< UOILM
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
permitcenter@spokanevalley.ora
'Z -
PERMIT NUMBER:
PERMIT FEE:
❑ Commercial 4 Residential
Building Owner /
Name:
Phone:
Fax:
Address: d
City
State:
Zip:
Contractor
Name: Q
Phone:
Fax:
Address:
City:
State:
Zip:
License No:
City Business 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 Prep/CulinaryMeat
DISHWASHER
CLOTHES WASHER
GARBAGE DISPOSAL
WATER SOFTNER
FLOOR DRAIN
Area, Case, Coil, Trench, Condensate
ROOF DRAIN/OVERFLOW DRAINS
FOUNTAIN, DRINKING
WATER PIPING/DRAIN-IN WASTE
Installation, Alterations, Repair, Reversals
WATER USING DEVICE
Ice and/or Coffee maker, hose bib, steamer proofer, carbonator, swam 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 ❑ CHECK ❑ VISA ❑ MC EXPIRES:
Card# VIN:
SIGNATURE:
CURRENT FEES AVAILABLE AT: http://www.spokanevalley.org/ under the quick links for Forms, Master Fee Schedule.
http://www.spokanevalley. org/uploads/Community_DevelopmentIDocumentsIForms/Building/PlumbingPermitApplicationO4O3O9. doc