2012, 05-18 Permit App: BLD-2012-0680 Plumbing Fixtures La11111 L,CAI G1
f–l`i J� 11703E Sprague Ave,Suite B-3
pokane Spokane Valley,WA 99206 PERMIT NUMBER:66 O Z. p 0
Valley (509)688-0036 FAX:(509)688-0037 PERMIT FEE: it `Q
permitcenter,spokanevalley.org �.Qp
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Community Development
Plumbing Permit Application n Commercial sidential
SITE ADDRESS: ,c�d l Al, f✓� r 4 ,,-- r
Building Owner ,3( 1,9 C /< ?_m X /�� Z�
Name: ,�/� S4-�l P �/�sC� Phone. (�cJ
Address: �% X/
Contractor �7 /' ( A City. .'/L Stater Z7 ?_./4
Name: Phone-
',7_ ' —77 Fax:
Address:
5,---z-- City: / State: Zip:
License No: City Business Lic:
Contact/Project Manager: 50L-vt-c_e
Name: Phone:
#OF UNITS
PLUMBING FIXTURE ON A TRAP
2-
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
i <
FOUNTAIN,
FOUNTAIN,DRINKING ,�C
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
el-
WATER HEATER If Gas,See Mechanical /
INDUSTRIAL WASTE PRETREATEMENT
INCEPTORS Including traps,vents except kitchen type grease interceptors functioning as fixture trapsZI
REPAIR OR ALTERATION Water piping,drainage or vent piping B
ATMOSPHERIC TYPE VACUUM BREAKER
94
BACK FLOW PROTECTIVE DEVICE Other than atmospheric type vacuum breakers
MEDICAL GAS a
W(t)
INCEPTORS
OCASH I]CHECK EKSA ❑MC EXPIRES:
Card# ) y(N:
SIGNATU'E/
'‘IP.----'''''
CURRENT FEES AVAILABLE AT:http://www.spokanevalley.orq/under the quick links for Forms,Master Fee Schedule.
http://www.spokanevalley.org/uploads/Community Development/Documents/Forms/Building/PlumbingPermitApplication040309.doc