2012, 08-03 Permit App: BLD-2012-1254 Plumbing Fixtures**lime
.0•10Valley„
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
permiteenter(c�spokaneval]ev. org
Community Development
Plumbing Permit Application
SITE ADDRESS:
C
z.�
131-0
. wiz. • 11
PERMIT NUMBER:
5"
PERMIT FEE: ( -73.00
Commercial Residential
Card#
SIGNATURE:
❑ VISA ❑ MC
EXPIRES:
CURRENT FEES AVAILABLE AT: http://www.spokanevalley.orgf under the quick links for Forms, Master Fee Schedule.
http://www.spokanevalley.orp_/uploads/Community Development/Documents/Forms/Building/PIumbingPermitApp]ication040309.doc
Building Owner
Name: -r - J; .. / Phone:
r ���J /v ✓` ��� S C1 j r j' Fax:
Address: / / (' e- 6/14 c •{ ley
C t / 0,,e- ', Cin I
fl1 r roll- %K_-(r.State: LL/2.
Zip:
Contractor �.
i
Name: /��� `` j _/
.).✓L- -' /ri;M h H E,,, Phone: Cy C�>;:-)g,
C (5 Fax:
Address: �? / �q %
�t2 710,../._ rie':. � ,, City: ! `e,,r_ ,1C /r.ic. State: /0.
Zip: , /
License No: f- ) P�/� q 6/ 7 City Business Lie:
Manager:
c7'3c�Ft
Contact/Pject
��ro
Name: .QVC •:h n.7 f Phone: _Tox (.7-.6,,��
# 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
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
INDUSTRIAL
If Gas, See Mechanical
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
Card#
SIGNATURE:
❑ VISA ❑ MC
EXPIRES:
CURRENT FEES AVAILABLE AT: http://www.spokanevalley.orgf under the quick links for Forms, Master Fee Schedule.
http://www.spokanevalley.orp_/uploads/Community Development/Documents/Forms/Building/PIumbingPermitApp]ication040309.doc