2012, 10-30 Permit App: BLD-2012-1965 Water Heater 00119. Permit Center
7"`* 1 17 03 E Sprague Ave,Suite B-3 PERMIT NUMBER:
Spokane Valley,WA 99206 �/
(509)688-0036 FAX:(509)688-0037 PERMIT FEE: ,41 7 t3 op
perm i tcenterrtiispokaneval lev.org
Community Development
Plumbing Permit Application 31111--
n Commercial Residential
�"C'
SITE ADDRESS: I I —7 t
Building Owner
Name: Phone: Fax:
Jo4,hTnIIP� 2<0-� 60,3/3/
Address: /how E 7,/& City: .5100ka [/u/<Py State: t4/4. Zip:qvc
Contractor 5�
Name:506 Phone: Fax:
,Spa kCr n 2 +— I S , ll c1 S/— GSG 7
Address:52 Z U A/ �JU h et —J City: 5 tl��yh f State: etik Zip: 9922
License No: sp, F-Pgz�1-� City Business Lic: ye 5
Contact/Project Manager:
Name: , Phone: 96:7_6 s•—e--7
JL #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
OCASH ❑CHECK ❑VISA ❑MC EXPIRES:
Card# VIN:
SIGNATURE:
P:\Community Development\02 Administration\03 Forms-Official Versions\Permit Center\Plumbing Permit Application 04-03-09 dg.doc