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2012, 10-15 Permit App: BLD-2012-1829 Plumbing Fixturespookane Valley# Permit Center 11703 E Sprague Ave, Suite B -3 Spokane Valley, WA 99206 (509)688 -0036�:(509)688 -0037 permitcenter@sn7Fanevalley.org Community Development Plumbing Permit Application PERMIT NUMBER: 'ERMIT FEE: n Commercial Residential SITE ADDRESS: [ ? 11.Z E 4 `' j jc)Jr C— ❑CASH ❑ CHECK ❑ VISA ❑ MC Card# SIGNATURE: EXPIRES: VIN: ED OCT 15 2012 CSV PERMIT CENTER SUB REV. # I—'" CURRENT FEES AVAILABLE AT: http: / /www.spokanevalley.org/ under the quick links for Forms, Master Fee Schedule. http: / /www.spokanevalley.org /uploads /Community Development/ Documents / Forms / BuildingJ PIumbingPermitApp lication040309.doc nmiamg owner Name: M 411._ g Phone: Spy 15-1 7 s l s-- Fax: Address: j? 112 E a-v. c=14— City: SPA lJ.:.l State: Zip: 1, EA b Contractor Name: Phone: Fax: Address: City: State: Zip: License No: City Business Lic: Contact/Project Manager: Name: 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 /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 ' ❑CASH ❑ CHECK ❑ VISA ❑ MC Card# SIGNATURE: EXPIRES: VIN: ED OCT 15 2012 CSV PERMIT CENTER SUB REV. # I—'" CURRENT FEES AVAILABLE AT: http: / /www.spokanevalley.org/ under the quick links for Forms, Master Fee Schedule. http: / /www.spokanevalley.org /uploads /Community Development/ Documents / Forms / BuildingJ PIumbingPermitApp lication040309.doc