2016, 03-22 Permit App: BLD-2016-0907 Plumbing Fixtures Community
Development
Permit Center 611)-
Nf
20J'
CI"TOrl 11703 E Sprague Ave,Suite B-3 Project #
Spokane Valley,WA 99206 RECEIVE
D
Valleyy PHONE: (509)720-5240991
FAX: (509)688-0037
MAR 2 2 2016
PERMIT FEE:
Plumbing Permit Application ❑ Commercial ❑ Residential GLV PCRM11 :tdTCR
SITE ADDRESS: /33 /Z z Nero lr 4 `- T
Building Owner /,r 4-n i-e p r) s e c
Name: Phone: Fax:
Address: City: State: Zip:
Contractor r- �L.YA -e
Name: ,l�.S,r L imooLJI Y Phone: Fax:
Address: 36 9( L' 4-<2/ / hu �` City: State: Zip:
License No: V l City Business Lic:
Contact/Project Manager:
Name: Phone:
#UNITS
PLUMBING FIXTURE ON A TRAP
TOILETS
URINALS
TUBS I
SHOWERS(per trap)
Lav/Basins,Bar,Floor,Kitchen,Laundry,Utility,Janitor,Photo,X-ray,Food,
SINKS 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 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
Signature
CURRENTF ESA AILABLE AT:http://www.spokanevalley.orq/under the quick links for Forms,Master Fee Schedule.