2014, 05-14 Permit App: BLD-2014-1063 Plumbing Fixtures D
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AgatI I . %i l• fa E SpraguValley, Ave,Suite B-3 PERMIT NUMBER: i� (Q(p�j
Spokane Valley,WA 99206
(509)688-0036 FAX(509)688-0037 PERMIT FEE:
peamitcenter®sookaneval lev.org
Community Development
Plumbing Permit Application
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SITE ADDRESS: 1 S. 5F-7 YC/C e / , _r-Pa iAJC ✓`� . W,� -9.4/O
gadding OwnerL_.1\.{L�( /�
Name: !TCJfYi .c,„3 L� Phone.SV't\ t L
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pad, UI1 SQ ) C'Y.561aWL VA-are state W/4" zip 99/14,
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Name: LJJL 1461144j.J C? Phone 7i / Fax:Addrea
D-)( rJ iJl�t)F L rf S� % Ci elasin,4 .Lt. State: VIM' Zip:17 C/a;
License No: Z.A.l il..!'^TUi�" L t..i� City Business Lic:
CoataitYPirejed Bili Ater: -
Name: j) (ZE-ki kit(IC Phone' I
PLUMBING FIXTURE ON A TRAP *OF UNITS
TOILETS
etAURINALS
TUBS
SHOWERS(per trap)
SINKS Lay/Basins,Bar,Floor,Kitchen,Laundry,Utility Janitor,Photo,X-ray,Food, 1
Prep/Cullnary Meat
DISHWASHER
CLOTHES WASHER
GARBAGE DISPOSAL I
WATER SOFTNER
FLOOR DRAIN
Area,Case,Coil.Trench,Condensate
ROOF DRAIN/OVERFLOW DRAINS
FOUNTAIN DRINKING
WATER PIPINGJDRAIN-IN WASTE
installation,Alterations R-•air Reversals
WATER USING DEVICE Ice endtor Coffee maker,hose bib,steamer proofer,carbonetor,swamp cooler
PRIVATE SEWAGE DISPOSAL SYSTEM
WATER HEATER
INDUSTRIAL WASTE PRETREATEMENT If Gas See Mechanical
INCEPTORS Indud.
Ira• vents exce• kitchen t •. ,reuse Interne•ors funetionin•
REPAIR OR ALTERATION es fixture Ira.
Water •'n, drain •e or vent•i•In.
ATMOSPHERIC TYPE VACUUM BREAKER
BACK FLOW PROTECTIVE DEVICE
Other than atmo-.•hent • vacuum breakers
MEDICAL GAS
INCEPTORS
OCASH O CHECK O VISA OMC EXPIRES:
Card#
VIN:
SIGNATURE:
P:\Community Development432 Administration\03 Forms-Official VersionstPermit Center\Plumbing Permit Application 04-03-09 dg.doc
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