2014, 01-03 Permit App: BLD-2014-0012 Plumbing Fixtures ' Community Development
Permit Center PERMIT NUMBER:
r
S o°Fkane 11703 E Sprague Ave,Suite B-3
PERMIT FEE:
Spokane Valley,WA 99206
jValley° PHONE: (509)720-5240
FAX: (509)688-0037
Plumbing Permit Application 0 Commercial esidential
SITE ADDRESS: 3 bo et _ Jr`�i '� °q AU
Building Owner Doi! 1 0 re 4
Name: O 4 o, � �f- ��� Phone: / y 8_ cLeGI? G Fax:
Address: -a State: GU/4... Zip: Qy ZU G=
��� C( S . Ui•cy,ur� CGiJ City: ��fl_t`L tau t'�
Contractor self
Name: Phone: Fax:
Address: City: State: Zip:
License No: City Business Lic:
Contact/Project Manager:
Name: Phone:
#UNITS
PLUMBING FIXTURE ON A TRAP
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
GARBAGE DISPOSAL
WATER SOFTNER
FLOOR DRAIN Area,Case,Coil,Trench,Condensate
ROOF DRAIN/OVERFLOW DRAINS
FOUNTAIN,DRINKING
4—WATER PIPING/DRAIN-IN WASTE Installation,Alterations,Repair,Reversals
'4 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
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Signature _ -„--- p
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CURRENT FEES AVAILABLE AAVhttp://www.spokanevallev.ora/under th uick links foforForm Master Fee Sche�ule.
RECEIVED ,
i 15 i
JAN (i 1,1114
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http://www.spokanevalley.org/filestorage/124/938/210/948/1496/2743/Plumb App.doc LsuBL -