Loading...
2011, 10-06 Permit App: 11003172 Plumbing Fixtures ♦ r e I Permit Center a,*nr 11703 E Sprague Ave,Suite 13-3 PERMIT NUMBER: l I3 j 7 Z Spokane Valley,WA 99206 4000 1leY (509)688-0036 FAX:(509)688-0037 PERMIT FEE: .—PcX perm itccn ter(i e spoka n cva I I c y.org Community Development Plumbing Permit Application ElCommercial KResidential SITE ADDRESS: _ 15—8 b a E 2.t 5+ A vc, L/5Z-52, P/0( Building Owner Name: Phone: Fax: KFlrr � �1AQZ.tA DE'�/FtJ�'uSz-T 44 3 - 3 2a$' Address: g Z i sk AYE City: J r vait State: WA Zip: q9 O 3 Contractor I Name: d IA.'M ESZ- Phone: Fax: Address: City: State: Zip: License No: City Business Lie: Contact/Project Manager: Name: 0 W 1J ER Phone: #OF UNITS PLUMBING FIXTURE ON A TRAP TOILETS URINALS TUBS SHOWERS(per trap) Lav/Basins,Bar,Floor,Kitchen,Laundry,Utility,Janitor,Photo,X-ray,Food, SINKS Prep/Culinary Meat DISHWASHER 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 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: P:\Community Development\02 Administration\03 Forms-Official Versions\Permit Center\Plumbing Permit Application 04-03-09 dg.doc