2016, 02-22 Permit App: BLD-2016-0483 Plumbing Fixtures Community Development
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Permit Center
11703E Sprague Ave, Suite B-3 Project #6 -20/(0- 913
RECEIVED1 � C
®SValley�
P n Spokane Valley,WA 99206 C
PHONE: (509)720-5240
FAX: (509)688-0037FEB 2 2 2016
P� IT,FEE:
Plumbing Permit Application
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SITE ADDRESS: it4/1/4 /"/ -�� i SUB #
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Building Owner i /4'cc'-s f ��c1G/�7 A Su?'!S
Name: ,[�/ x_s Phone:25-43 y/c , Fax:
' State: Zip:
Address: rj/3 Lr-----_ dn'!4�rCkx�f/ City: L � �;/� ?to/F.
Contractor
5471-4-6-
Name:
Name: Phone: Fax:
Address: City: State: Zip:
License No: City Business Lic:
Contact/Project Manager: 5-41.41,c
Name: Phone:
#UNITS
PLUMBING FIXTURE ON A TRAP
TOILETS
0
URINALS
TUBS i
SHOWERS(per trap) 1
Lav/Basins,Bar,Floor,Kitchen,Laundry,Utility,Janitor,Photo,X-ray,Food,
SINKS Prep/Culinary Meat
DISHWASHER ip
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 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 I
INCEPTORS 'i j
Signature ax4�
CURRENT FEES AVAILABLE AT: http://www.spokanevallev•orq/under the quick links for Forms,Master Fee Schedule.