2012, 08-15 Permit App: BLD-2012-1322 Plumbing FixturesSpokane
..FMalley�
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
permitcenterc spokanevallev.org
Community Development
Plumbing Permit Application
SITE ADDRESS: / /9 /
Z -132Z
`PERMIT NUMBER:
PERMIT FEE:
(1 Commercial-esidential
Building Owner
Name:fir': Phone: Fax:
Address: 1 I - k i f) 4 •\J\ {-"j i (^„ lUI City: State: Zip:
1 \(
Contractor
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Name:1
Phone: Fax:
Address: II c S c.t_- I N. Cir -€_ ,f City:.sio o k. %n_k State: c_..A..) Zip: 61 cJ
2 y
License No.'71Ct_��, !I•i r j c y il City Busmess Lic:
Contact/Project Manager:
Name: Phone:
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# OF UNITS
PLUMBING FIXTURE ON A TRAP
TOILETS
(%'1
URINALS
TUBS
SHOWERS (per trap)
1
SINKS
Lav/Basins, Bar, Floor, Kitchen, Laundry, Utility, Janitor, Photo, X-ray, Food,
Prep/Culinary Meat
q
DISHWASHER
1
CLOTHES WASHER
I
GARBAGE DISPOSAL
I
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, swamp 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
DCASH ❑ CHECK YVISA ❑ 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