2013, 02-07 Permit App: BLD-2013-0206 Plumbing Fixtures 02/07/2013 08:32 5099288998 UNITED PLUMBING PAGE 01
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Plumbing Permit Application ❑ Commercial El Residential
SITE ADDRESS: - I L + E t3
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City; • State: Zip:
Name: (•a-Lti '..eQ Phone: Fax:
Address: _ �iM i citY: Ca• ( L� State: Zip; .2..p,License No: p (I t - City Susideas Lie:
ColitarCtlPrti3iict Managers',: , r '••' ' �.. •• . ., � ::.•'; • . • .
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Name: Phone:
r I #OF UNITS
PLUMBING FIXTURE ON A TRAP —
_ •
TOILETS
URINALS
TUBS
SHOWERS(per trap)
Lay/Basins,Bar,Floor,Kitchen,Laundry,Utility,Janitor,Photo,X-ray,Food,
•SINKS Pre.1Cu11na rt�M®at
DISHWASHER •
CLOTHES WASHER
GARBAGE DISPOSAL —
WATER SOFTNER
FLOOR DRAIN Araa,Case,'Coll,Trent',Condensate
ROOF DRAIN/OVERFLOW DRAINS
FOUNTAIN,DRINKING
WATER PiPING/DRAIN-IN WASTE Installation,Altsratio_,s Repair,Reversals C
WATER USING DEVICE Ica and/or Cottee maker hose bib steamer•roofer catbonator swam-cooler --
PRIVATE SEWAGE DISPOSAL SYSTEM •
WATER HEATER It Gas,See Mechanical
INDUSTRIAL WASTE PRETREATEMENT
INCEPTORS Inch:din'tre.avents env. kitchen -a-reaselntare=-tomfunctionin-aslixturatra.s
REPAIR OR ALTERATION _ Water piping,drainage or vent Keg .--
ATMOSPHERIC TYPE VACUUM BREAKER
BACK FLOW PROTECTIVE DEVICE Other than atmospheric type vacuum breakers
MEDICAL GAS ,
INCEPTORS
ViNage
feeria_
❑CASH 0 CHECK k,VISA ❑MC EXPIRES: REDAC1 tU •
Cardia REDACTED '''N REDAG 1 tU
SIGNATURE
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This document originally contained confidential credit card / Co
' information which was redacted pursuant to RCW 19.255.010 /.-, F%-
and the original document destroyed pursuant to SOS DAN —r
CURRENT FEES AVAILABLE AT:htfp://wwJr GS2014-030. .1-(5
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