2012, 09-07 Permit App: BLD-2012-1515 Water HeaterSpokane
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Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
permitcenter cr,spokanevallev.org
Community Development
Plumbing Permit Application
SITE ADDRESS: / p.WS"-- 5Pra Gj (�e
� J � - 2 -LA k
PERMIT NUMBER:
PERMIT FEE:
n Commercial aResidential
Building Owner
Name:
lefuly WPar%y
Phone: 3/s— 95--�1
Fax:
Address:
I$ SOS L SprG(jG2
Ci /
City: SPDXCyn e I�i//C/
State:
Zip: Cf�
p ��
Contractor ✓J
Name:
Spo<u h e -ct. I (C PI vwt %,
Phone:
c.c./ - 6 50 7
Fax:
Address: SZ 2 O N E / o n C i --
City: 5,p0 ✓q h c_
State:
Gt)
Zip: 9C�2/z
License No: S 1" p O p p q - 3
City Business Lic: yeS
Contaet/Project Manager:
Name: sag J 1c(L r
Phone: Q6.7 —GS67
# 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
WATER USING DEVICE
PRIVATE SEWAGE DISPOSAL SYSTEM
Installation, Alterations, Repair, Reversals
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
DCASH ❑ 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