2014, 06-12 Permit App: BLD-2014-1373 Plumbing FixturesCommunity Development n
0000"*Permit Center _ �`'►J �,q�
CT1YCFF 11703 E Sprague Ave, Suite B-3 ,
Spokane Valley WA 99206
jV"y ` PHONE: (509) 720-5240
FAX: (509) 688-0037
PERMIT FEE:
Plumbing Permit Application ❑ Commercial ❑ kesidentlal
SITE ADDRESS:IL-
Building Owner 4_4le,
Name: Phone: c Fax: a, • f c;�
�3
Address: �.`' .i
City:State: �Zip:
��� �� �r�`"` .
Contractor
Name:
Phone: Fax:
Address:
City: State: Zip:
License No: 117 F— :— L '12
i / - City Business Lic:
Contact/Project Manager:
Name:
Phone:
# 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 Prep/CulinaryMeat
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 mak ,:L5;ose 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
Signature
CURRENT FEES AVAILABLE AT: http://www.spokanevalley.ora/ under the quick links for Forms, Master Fee Schedule.