2013, 08-26 Permit App: BLD-2013-1742 Plumbing Fixtures • L. i
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Permit Center ��Lb (3 I�j l�'l�
11703 E Sprague Ave,Suite B-3
Spokane Valley,WA 99206 PERMIT NUMBER:,�f
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(509)688-0036 FAX:(509)688-0037 PERMIT FEE: W IA•
permitcenter@sookaneval lev.orq
Community Development
Plumbing Permit
Application ❑ Commercial Residential
SITE ADDRESS: _ (,) J. Jk-z/e/ .e. .Srfi�G�L�Aiz- d a; i ��G/lam
Building Owner
Name: �� L. wan y�� /Lri'---F-300 Phone �/y, 7./ �1�j } Fax Q(�
Addre s�U N I/j/VI U&1LQ 17 � CityS���VttJe V/t�r Stare: wA_ Zip: /7 '676
coatrost.
lName: O�, U-OVVI Phoneb` y L v..11,0 Fax: qj,2-0/ /Addres.'o lLoutlaw CitTQiatic VA
State: 1,44- Zip:elcZa
License No: LAI Li40H L I?42, 1 L3 City Business Lic.
Contliii Pfoject 'Man ger: ll ,, ) �Jy /
Name: ] tJ i`LN Nl LZ- Phone: 5 qq- -/ /
#OF UNITS
PLUMBING FIXTURE ON A TRAP
TOILETS
URINALS
TUBS
SHOWERS(per trap) cg
SINKS Lav/Basins,Bar,Floor,Kitchen,Laundry,Utility,Janitor,Photo,X-ray,Food, �/
Prep/Culinary Meat �Y/
DISHWASHER
CLOTHES WASHER I
/
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 maker,hose bib,steamer proofer,carbonator,swamp cooler
PRIVATE SEWAGE DISPOSAL SYSTEM
WATER HEATER
INDUSTRIAL WASTE PRETREATEMENT If Gas,See Mechanical
INCEPTORS Including traps,vents except kitchen type YPe 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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OCASH 0 CHECK 0 VISA 0 MC EXPIRES: —7 c (3 r I lc A
Cards
VIN:
SIGNATURE:
P:\Community Development\02 Administration‘03 Forms-Official Versions\Permit Center\Plumbing Permit Application 04-03-09 dg.doL