2013, 03-29 Permit App: BLD-2013-0445 Sewer Community Development
Permit Center
11703 E Sprague Ave,Suite B-3
Spokane Valley,WA 99206
VA1 PHONE: (509)720-5240
FAX. (509)688-0037
&®- ZIN3 • 04115
PERMIT FEE: .a 45.00
Plumbing Permit Application ❑ Commercial ❑ Residential Q
SITE ADDRESS: I a S• S -1� 1..ci
Building Owner S...teA...cin 11.5%cotz.D.LeA
Name: Phone: Fax:
Address: • 5 S City: C peo k e \4,State: •w� Zip: qci Z�
Contractor 1 n L J
Name: G�J, r7l o t�,00 Phone:Phone: 5 3 •5 - 3 tj Fax:
Address: ` 1 ( 1 4 Stet tA , ,e City: S akciN G vas. State: 1� Zip: q (? a ( 7
License No: �1��tt 1 City Busir'ess Lic:
ContactProject Manager:
Name: Phone:
#UNITS
PLUMBING FIXTURE ON A TRAP
TOILETS
URINALS
TUBS
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
CURRENT FEES AVAILABLE AT: htto://www.spokanevallev.ora/under the quick links for Forms,Master Fee Schedule.