2014, 04-18 Permit App: BLD-2014-0827 Sewer PermitPermitCenter
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'J 11703 E Sprague Ave,Suite: 3 �, d/� NUMBER:
Spokane Valley,WA 99206 p f 0` I
j1�e . (509)688-0036 FAX:(509 �:: I I � ' FEE:
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Community Development
Plumbing Permit Application APR" J Q� / Co ercial KResidential
SrrEADDRESS: C3`/ iter PER-MIT CENTER
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: Zr
e G- L/1 ®W L 11,3 ,o.
Address: '3/e �• /60. ,9e.,_ City: spa l6. llr� Slate: Zip:
Contractor
Name: 'r�l /Yl ger Exc. .%,,1c Phone: l db A Fax 41 .1A- 50 i
Address: '7 "� E. Let++,cr A Je. City ,dC. WA : 9 9a►a
Limxo: L4RRV,Y)E 178'NT CityB�Is lac: '
Contact/Project Manager: •
Name: Phone:
#OF UNITS
PLUMBING FIXTURE ON ATRAP
TOILETS
URINALS
TUBS
SHOWERS(per trap)
Lav/Basi ns,Bar,Floor,Kitchen,Laundry,Utility,Janitor,Photo,X-ray,Food,
SINKS Pren/Culnary Meat
DISHWASHER
CLOTHES WASHER
GARBAGE DISPOSAL
WATER SOFTNER
FLOOR DRAW Area,Case,Coil,Trench,Condensate
ROOF DRAIN/OVERFLOW DRAINS
FOUNTAIN,DRINKING
WATER PIPING/DRAIN-IN WASTE /74 th`G4!/"Ifnstafation,Alterations,R �Revensals rj vc. e-r)
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
OCASH 0 CHECK 0 VISA 0 MC EXPIRES:
Caul VIN:
SIGNATURE:
0000110111111111111114?
iv
CURRENT FEES AVAILABLE AT:httpi/www.spokanevailey.orof under the quick finks for Forms,Master Fee Schedule.