2011, 09-29 Permit App: 11003076 Water HeaterSpol ane
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11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
perrnitcenter@spokanevallev.org
Community Development
Plumbing Permit Application
PERMIT NUMBER: t
PERMIT FEE:
11 Commercial Residential
SITE ADDRESS:
Building Owner . l '
Name:
Phone:
Fax:
Address:D ���
City:
State:
Zip:
Contractor
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Phone:
Fax:
Address: & 7767 Gc) ���/ /1, _ m
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State: ' ,j
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Zip:
License No: /`/e_('N �J-c'ss S
City Business Lic:
Contact/Project Manager:
Name:
Phone: L -19v._3
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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
FOUNTAIN, DRINKING
WATER PIPING/DRAIN-IN WASTE
Installation, Alterations, Repair, Reversals
WATER USING DEVICE
PRIVATE SEWAGE DISPOSAL SYSTEM
Ice and/or Coffee maker, hose bib, steamer proofer, carbonator, swamp cooler
WATER HEATER
INDUSTRIAL WASTE PRETREATEMENT
INCEPTORS
If Gas, See Mechanical
REPAIR OR ALTERATION
Including traps, vents except kitchen type grease interceptors functioning as fixture traps
ATMOSPHERIC TYPE VACUUM BREAKER
BACK FLOW PROTECTIVE DEVICE
Water piping, drainage or vent piping
Other than atmospheric type vacuum breakers
MEDICAL GAS
INCEPTORS
❑CASH Eg 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