2014, 06-26 Permit App: BLD-2014-1513 Plumbing Fixtures B
Permit Center
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San 11703 E Sprague Ave,Suite B-3 PERMIT NUMBER
oave Spokane Valley,WA 99206 Pr t ,
Valley' (509)688-0036 FAX:(509)688-0037 PERMIT FEE:
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Community Development Iv,
Plumbing Permit Application H Cojk)Nee•1201411 Residenti41
STYE ADDRESS: _ 137/0 E J/a//Py Je C51/ PERMt I CENTER
Building Owner .
Name: Phone: .
Address: City: State: Zip:
Contractor � b5
Nam O J E- At/ER P(6 f r[.UMOi 06 Phone(So(I) Y99-363 I Fax:
Address: City: State: Zip:
License No: &a QV E \ )g73 148 City Business Lie:
Contact/Project Manager.
Name: "? /,1/41 t vp_t l.SDtJ Phone(5c ) gq,
#OF 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 (rJ
DISHWASHER 2.
CLOTHES WASHER 2—
GARBAGE
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 2.
WATER USING DEVICE Ice and/or Coffee maker,hose bib,steamerproofer,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
['CASH 0 CHECK 0 VISA ❑MC EXPIRES:
Card# VIN:
SIGNATURE:
CURRENT FEES AVAILABLE AT:http://www.spokanevalley.org/under the quick links for Forms,Master Fee Schedule.
http://wwwspokanevalley.org/up loads/Community_Development/Documents/Forms/Building/PlumbingPermitApplication040309:doc