2011, 05-05 Permit App 11001196 Plumbing Fixtures_ 'T� Permit Center
S Olds e 11703 E Sprague Ave, Suite B-3 PERMIT NUMBER:
P ��nT��� Spokane Valley, WA 99206
" "—✓ " (509)688-0036 FAX (509)688-0037 PERMIT FEE:
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Community Development
Plumbing Permit Application ❑ Commercial Residential
SrFEADDRESS: 2-3z-2- Ilv. <ferea—CA-
Building Owner
Name: �a+�e`o5 �..
Phone: Fax
Address: N(6ei A-) cSf
crn' NEc�I.,p� dAl State: I.A
zip:,? �rG ZS
Contractor 5. .4
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Name: /, '/ Lzf
Phone: `9s.3 • 971 ? Fax:
Address: y9y3 ci
city: Spm_ State: (e.df
Zip: 9F2- 23"
License No: Ser~ 6 Ce 92 3 City Business Lic:
Contact/Project Manager.
Name: l
Phone:
# OF UNITS
PLUMBING FIXTURE ON A TRAP
TOILETS
URINALS
TUBS
SHOWERS(per trap)
SINKS
Lav/Basins, Bar, Floor, Kitchen, Laundry, Utility, Janitor, Photo, X-ray, Food,
Prep/Cullnary Prep/CulinaryMeat
DISHWASHER
CLOTHES WASHER
GARBAGE DISPOSAL
WATERSOFTNER
FLOOR DRAIN
Area Case Coil Trench Condensate
ROOF DRAINIOVERFLOW DRAINS
FOUNTAIN DRINKING
WATER PIPING/ORAIN-IN WASTE
Installation Alterations Repair, Reversals
WATER USING DEVICE
Ice and/or Cottee maker, hose bib steamer proofer, carbonator, swamp cooler
PRIVATE SEWAGE DISPOSAL SYSTEM
WATER HEATER
If Gas See Mechanical
INDUSTRIAL WASTE PRETREATEMENT
INCEPTORS
IncludInn ira s,ventse tkitchen type gresse interceptors functionin as fixturetre
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 ❑ CHECK ❑ VISA ❑ MC EXPIRES:
Card# VIN:
SIGNATURE:
CURRENT FEES AVAILABLE AT: htto://www.spokanevalley.org/ under the quick links for Forms, Master Fee Schedule.
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