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2011, 01-10 Permit App: 11000037 Plumbing Fixtures
an tr�ne �IIr's' alley, Permit Center 11703 E Sprague Ave, Suite B-3 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 permitcenternspokaneval ley. org Community Development Plumbing Permit Application (ciCO py PERMIT NUMBER: 1 —S PERMIT FEE: SITE ADDRESS: 6: as ❑ Commercial IKResidential Card SIGNATURE: ECK ❑ VISA TSMC EXPIRES: LC_.e igox ss'en(9?) 6e - fop'P:\Community Development\02 Administration\03 Forms - Official Versionsmit Center\Plumbing Permit Application 04-03-09 dg.doc Building Owner Name: Phone: Fax: Address: City: State: Zip: Contractor n�,Phone: !� p Fax:� / Name: A.Jc- Gwrl c�.✓1 4141 6,.11. rs� a/1� 7%Z O-�d „Jr.- 7 /O� "`�s ��© Address: -75--&:„. Alz 6.-.,,,,,..--‘4_,...c„, / City: V mr/ a'/✓ %atrYe State: �A Zip. f l?0 /1" License No: PLB-C-10406 f City Business Lic: Contact/Project Manager: Name: zasrLf it, e4, 4.44,,I_ Phone: o 6--6.-/__.revt�*S,/-- �'J # OF UNITS PLUMBING FIXTURE ON A TRAP TOILETS URINALS TUBS / SHOWERS (per trap) OZ 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 0 FOUNTAIN, DRINKING WATER PIPING/DRAIN-IN WASTE Installation, Alterations, Repair, Reversals isen AD WATER USING DEVICE - Ice and/or Coffee maker, hose bib, steamer proofer, carbonator, swamp cooler PRIVATE SEWAGE DISPOSAL SYSTEM .63 ' 9) WATER HEATER If Gas, See Mechanical / INDUSTRIAL WASTE PRETREATEMENT INCEPTORS Including traps, vents except kitchen type grease interceptors functioning as fixture traps SO REPAIR OR ALTERATION Water piping, drainage or vent piping ATMOSPHERIC TYPE VACUUM BREAKER BACK FLOW PROTECTIVE DEVICE Other than atmospheric type vacuum breakers 50 MEDICAL GAS 0 INCEPTORS Or Card SIGNATURE: ECK ❑ VISA TSMC EXPIRES: LC_.e igox ss'en(9?) 6e - fop'P:\Community Development\02 Administration\03 Forms - Official Versionsmit Center\Plumbing Permit Application 04-03-09 dg.doc