2011, 10-26 Permit App: 11003415 Plumbing FixturesPermit Center
Sriokane 11703 E Sprague Ave, Suite B-3
P TA' Spokane Valley, WA 99206
VCllle�` (509)688-0036 FAX: (509)688-0037
permitc,enter@spokanevalley.org
Community Development
Plumbing Permit Application
PERMIT NUMBER: l ` :5415
PERMIT FEE:
n Commercial Residential
SITE ADDRESS: 1— 5 0 3 r!= S' 7" 4 V
SPO /c v t Y 9 9 al a
Building Owner
Name: D A L L, s l4 N4)&7? s oN Phone: 5-0 9 g- 3 5- Q [/ 9 Fax:
Address: 1 5-03 L S T b 4. l/k City: ,SPO k 1.1 NG YL Y State: l.ci
Zip: ? ? 2 / Z
Contractor 0 14//s/ t iR
Name: Phone: Fax:
Address: City: State:
Zip:
License No: City Business Lic:
Contact/Project Manager:
Name: Phone:
# OF UNITS
PLUMBING FIXTURE ON A TRAP
K TOILETS
`
URINALS
TUBS
SHOWERS (per trap) ri
l
SINKS
Lav/Basins, Bar, Floor, Kitchen, Laundry, Utility, Janitor, Photo, X-ray, Food,
Prep/Culinary Meat
l
l
DISHWASHER
CLOTHES WASHER
GARBAGE DISPOSAL
WATER SOFTNER
X FLOOR DRAIN
Area, ase, 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
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
❑CASH 0 CHECK 0 VISA 0 MC EXPIRES:
Card# VIN:
SIGNATURE:
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