2015, 05-15 Permit App: BLD-2015-1105 Plumbing Fixtures Community Development / t���15. US
Permit Center Project ,LJ. W
S okane 11703E Sprague Ave,Suite B-3
Spokane Valley,WA 99206 RECEIVED
4.00 ailey PHONE: (509)720-5240
FAX: (509)688-0037 MAY 15 2015
• PERMIT FEE:
Plumbing Permit Application 0 Commercial VI Residential CSV Un-j;ii Rn i i i 'I-NI l I-I-z
SITE ADDRESS: / 1 yy SUB # REV. 1
Building Owner
Name: Phone: et 9.5"-( 6121 Fax:
Address: 3iZc> S, cSkt�cJc� //
2� l�i S .. City:S9,2)CCis- UR,I(y State:w Zip'QCz,t L
Contractor {(�
Name: S� T Phone: Fax:
Address:
City: State: Zip:
License No: City Business Lic:
Contact/Project Manager:
Name: Phone: Q5-1_L. I -Li
I #UNITS
PLUMBING FIXTURE ON A TRAP
•TOILETS
URINALS 3TUBS 'j
SHOWERS(per trap) /'rJ
Lav/Basins,Bar,Floor,Kitchen,Laundry,Utility,Janitor,Photo,X ray,Food, /
SINKS Prep/Culinary Meat
t{
DISHWASHER t
CLOTHES WASHER •
0
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• Z
WATER USING DEVICE Ice andlor Coffee maks'�hose bisteamer proofer,carbonator,swamp cooler
PRIVATE SEWAGE DISPOSAL SYSTEM
WATER HEATER If Gas,See Mechanical y 5
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 TYPEVACUUM BREAKER
BACK FLOW PROTECTIVE DEVICE s'twte.-C.- Other than atmospheric type vacuum breakers
MEDICAL GAS
INCEPTORS
Signature
C RRENT FEES AVAILABLE AT:http://www.sootcanevaliev.orq/under the quick links for Forms,Master Fee Schedule.