2012, 10-24 Permit App: BLD-2012-1838 Plumbing Fixtures Permit Center
an or 1101"11\11ftrit. 11703 T NUMBER: �4— / " d -�
Spokane Valley,WAlike6
—_✓ (509)688-0036 FAX:(509)688-0037 PERMIT FEE:
permitcenter a?spokanevalley.org
Community Development
Plumbing Permit �
Application /? 0 Commercial ® Residentialsi
SITE ADDRESS: 5-N)G� A ) ��L ?�l`� Ch'• _S�� l/' �-C, ' Lc/� / (/�
Building Owner
Name: Phone: Fax:
Address: City: State: Zip:
Contractor
Name:LEWIS CONSTRUCTION&DEVELOPMENT,INC Phone:509-951-6959 Fax:509-279-0967
Address:8225 N Division-Suite A City:SPOKANE State:WA Zip:99208
License No:LEWISCD917BN City Business Lic:602-728-595
Contact/Project Manager:
Name:Tim Lewis Phone:509-951-6959
#OF UNITS
PLUMBING FIXTURE ON A TRAP
TOILETS 2
URINALS
TUBS 2
SHOWERS(per trap) 1
Lav/Basins,Bar,Floor,Kitchen,Laundry,Utility,Janitor,Photo,X-ray,Food,
SINKS Prep/Culinary Meat 4
DISHWASHER 1
CLOTHES WASHER 1
GARBAGE DISPOSAL 1
WATER SOFTNER
FLOOR DRAIN Area,Case,Coil,Trench,Condensate 1
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,swamp cooler 4
PRIVATE SEWAGE DISPOSAL SYSTEM
WATER HEATER If Gas,See Mechanical gas
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
OCASH 0 CHECK ®VISA 0 MC EXPIRES:
Card# VIN:
SIGNATURE:
CURRENT FEES AVAILABLE AT: http://www.spokanevallev.orq/under the quick links for Forms,Master Fee Schedule.
F:\Ron Vandamne to be transfered to new computer\Permit Docs\5206 N Keller- 2012.10.15 Plumbing Permit Application.doc