2013, 08-26 Permit App: BLD-2013-1744 Plumbing Fixtures Permit Center
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�� 11703 E Sprague Ave,Suite B-3 PERMIT NUMBER:
Spokane Valley,WA 99206
' (509)688-0036 FAX:(509)688-0037 PERMIT FEE: 4, 1 ( -CO
permitcenter@sookanevallev.org
Community Development
Plumbing Permit Application ����� El Commercial Residential
SITE ADDRESS: A 3 � i .. 57 Si Val 0/�I��Z C�l f� f� /
Building O)wn�erf (l ��n L / /�7y /tit �f �/�
Name:d `LA /L /T,U/f a /LLL Phone:A����'t�,jtZ''Z4 - o f Fax ' 12- —0/ / �
Ad,ZJ b N uNit h1ZQ 17 N E 300 City.s6K �/e V)Lir( State: wA.- Zip:?nue,
Conti 4 t rr//��,�� ��yy( iL r J
Name: /JJL 1.4.604 G Phonne�p"�I ��7 ,/'�/�JL // Fax: qz, -ol y
Address-)( til• II ii / ) y►L. �()() Ci''.�7OftiltICVAL.lG7 State: }I Zip:54' ,6
License No: �LI4OR . I u3 City Business Lic:
Codfli t7Pfrtject Mdanll4�rer. l
Name: J)f J RE-1J N{( )( Phone: 5 go- I g
#OF 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 Meat
DISHWASHER /
CLOTHES WASHER /
GARBAGE DISPOSAL ,
WATER SOFTHER
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 3
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 0 CHECK 0 VISA 0 MC EXPIRES:
Card# VIN:
SIGNATURE: I
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P:\Community Development\02 Administration\03 Forms-Official Versions\Permit Center\Plumbing Permit Application 04-03-09 dg.doc
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