2014, 04-02 Permit App: BLD-2014-0637 Plumbing Fixtures Community Development
siklialts•°ce Permit Center
11703 E Sprague Ave,Suite B-3
Spokane Valley,WA 99206
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J PHONE: (509)720-5240 Project
FAX: (509)688-0037 - RECEIVE
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Plumbing Permit Application E] Commercial X Residential APR pET FEE: (612
SITE ADDRESS: 11920 E 38th Ave Spokane Valley, WA 99206 CSV PERMIT CENTER
Building owner S U B , - / REV. # 1-1
Name:Jeffrey Clark Phone:509-926-0670 Fax:
Address: 11920 E 38`"Ave City:Spokane Valley State:WA Zip:99206
Contractor
Name:Self Phone: Fax:
Address: City: State: Zip:
License No: City Business Lic:
Contact/Project Manager:
Name:Self Phone:509-926-0670
#UNITS
PLUMBING FIXTURE ON A TRAP
TOILETS 1
URINALS
TUBS 1
SHOWERS(per trap)
Lay/Basins,Bar,Floor,Kitchen,Laundry,Utility,Janitor,Photo,X-ray,Food,
SINKS Prep/Culinary Meat 1
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
Signature , f
CURRENT FEES AVAILABLE AT:http://www.spokanevaliev.orq/under the quick links for Forms,Master Fee Schedule.