2011, 10-21 Permit App: 11003351 Plumbing Fixtures t '
Permit Center
xr+(s 11[iliL 11703E Sprague Ave,Suite B-3 PERMIT NUMBER: ` J 53S\
11[ilit Spokane Valley,WA 99206
W I ' (509)688-0036 FAX:(509)688-0037 PERMIT FEE: --TZ.-----
penn i tcenter(di spoka n oval l ey_org
Community Development
Plumbing Permit Application n Commercial n Residential
SITE ADDRESS: 13919 E 12th Ave. Spokane Valley, Wa. 99037
Building Owner Dan Groby
Name: Dan Groby Phone:=2.41.40 To Fax:
Address: 13919 E 12th Ave City: Spokane Valley State:WA zip:99037
ContractorCovington Construction/Peak Plumbing
Name: Phone:s-Q1 46
65-To Fax:s`:31 e/C t QO��
Address: 1324 Liberty Lake City: Liberty Lake State: WA a I Zip: 99019
License No: COVINCR944CH City Business Lie: 602-840-042
Contact/Project Manager:
Name: Da.�.. '4}u�e,►-�-�- S011cct. Phone:
Soy 7144_blo 3
eAvIO-- Sjest— 50
Sic 593. #OF UNITS
PLUMBING FIXTURE ON A TRAP
TOILETS 1
URINALS
TUBS
SHOWERS(per trap) 1
Lay/Basins,Bar,Floor,Kitchen,Laundry,Utility,Janitor,Photo,X-ray,Food,
SINKS Prep/Culinary Meat 2
DISHWASHER 1
CLOTHES WASHER
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 If Gas,See Mechanical 1
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
OCASH El CHECK 0 VISA 0 MC EXPIRES:
Card# VIN:
SIGNATURE:
P:\Community Development\02 Administration\03 Forms-Official Versions\Permit Center\Plumbing Permit Application 04-03-09 dg.doc