2012, 02-23 Permit App: BLD-2012-0016 Plumbing FixturesS#0
jsValley°
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
permitcentere,spokanevallev. ore
1-3 l C4 1 y-- (w
PERMIT NUMBER:
PERMIT FEE:
Community Development
Plumbing Permit Application ❑ Commercial Residential
SITE ADDRESS: _ % C7 ;� 70 % N 2 c-.7' 77
u+on u i nci,n U vibA U MG EXPIRES:
Card# VIN:
SIGNATURE:
CURRENT FEES AVAILABLE AT:.http://www.spokanevalley.or�q under the quick links for Forms, Master Fee Schedule.
http://www.spokanevalley.org/uploadsICommunity_DevelopmentIDocuments/FonnsBuilding/PlumbingPermitApplicationO4O3O9. doc
Building Owner
nA/AZd
9L A/ In -e"--r
Name:
Phone: Fax:
Address:
City: State:
Zip:
Contractor
,
Name:
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/CulinaryPrep/Culinary Meat
DISHWASHER
CLOTHES WASHER
GARBAGE DISPOSAL
WATER SOFTNER
FLOOR DRAIN
Area Case Coil Trench Condensate
7i
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
7
PRIVATE SEWAGE DISPOSAL SYSTEM
WATER HEATER
INDUSTRIAL WASTE PRETREATEMENT
INCEPTORS
If Gas, See Mechanical
Including traps, vents except kitchen type grease interceptors functioning as fixture tra s
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
u+on u i nci,n U vibA U MG EXPIRES:
Card# VIN:
SIGNATURE:
CURRENT FEES AVAILABLE AT:.http://www.spokanevalley.or�q under the quick links for Forms, Master Fee Schedule.
http://www.spokanevalley.org/uploadsICommunity_DevelopmentIDocuments/FonnsBuilding/PlumbingPermitApplicationO4O3O9. doc