2010, 01-13 Permit App 10000095 Plumbing FixturesSpokan® e\``
40jValley.
Community Development
Plumbing Permit Application
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
permitcenter(a,spokanevallev.ore
SITE ADDRESS: % V (J I CL
PERMIT NUMBER: � -- -)
PERMIT FEE: `33
n Commercial VI Residential
Building Owner
Name:qq 1 Fax
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City: State: Zip: r 0IWu 1 3S •.L.lv�v,e`v C�v �pe�1n� c ,�� r 9 `1
Contractor��G �, VAC C.t %re. \ V--W� vv.:.
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Name: Phone: Fax:
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Address: to C1 \ 1p , cY r f2. A City: S Q k[J1rlp State. Zip: C2 et' t—
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LicenseNo: \ ci.ski— P q Li 1 4-1 City BusinLic:
Contact/Project Manager:
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Name: - fi--' 3 (CRs( ckwi \ h fle:
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# OF UNITS
PLUMBING FIXTURE ON A TRAP
TOILETS
3
URINALS
TUBS
SHOWERS (per trap)
i
SINKS
Lav/Basins, Bar, Floor, Kitchen, Laundry, Utility, Janitor, Photo, X-ray, Food,
Prep/Culinary Meat
DISHWASHER
r
CLOTHES WASHER
I
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
ff 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 ❑ CHECK ❑ VISA ❑ MC
Card#
SIGNATURE:
EXPIRES:
VIN:
CURRENT FEES AVAILABLE AT: http://www.spokanevalley.orq/ under the quick links for Forms, Master Fee Schedule.
http://www. spokanevalley.org/uploads/Community_DevelopmenUDocuments/Forms/B ui Iding/PlumbingPermitApplication040309. doe