2009, 06-29 Permit App: 09001924 Plumbing Fixtures Permit Center 11703 E Sprague Ave,Suite B-3 PERMIT NUMBER: )9Z,9
1111 Spokane Valley,WA 99206
4000valler (509)688-0036 FAX:(509)688-0037 PERMIT FEE: 7
permitcenterna spokanevalley.org
Community Development
Plumbing Permit Application n�Colm�mercial rlitesidential
SITE ADDRESS: 1(7)--)--V Lv]�l a/C/��''M p l (r
� W,€3 t'4 L q 61�j
Building Owner
Name: -To--.);1 ___� �,, I�,G ' Phone: G L' Fax: ,�/ 14, 1Address: a 2 c ` City: S ,ILeit
/ �1State: V l/l Zip: ��a GC
Contractor LJ J 16
Name: Phone: Fax:
Address: City: State: Zip:
License No: City Business Lic:
Contact/Project Manager:
Name: Phone:
#OF UNITS
PLUMBING FIXTURE ON A TRAP Z.
TOILETS ,
URINALS
TUBS 1
SHOWERS(per trap)
Lav/Basins,Bar,Floor,Kitchen,Laundry,Utility,Janitor,Photo,X-ray,Food,
SINKS Prep/Culinary Meat
DISHWASHER
CLOTHES WASHER t
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
OCASH ❑CHECK WISA ❑MC EXPIRES:
Card# VIN:
SIGNATURE:
CURRENT FEES AVAILABLE AT: http://www.spokanevalley.orq/under the quick links for Forms,Master Fee Schedule.
http://www.spokanevalley.org/uploads/Community_DevelopmenUDocuments/Forms/Building/PlumbingPermitAppl ication040309.doc