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2012, 05-14 Permit App: BLD-2012-0637 Plumbing FixturesY 11703 E Sprague Ave, Suite B-3 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 permitcenter@sookanevallev. ore Community Development Plumbing Permit Application SITE ADDRESS: 30 r PERMIT NUMBER: B — la -6 3 PERMIT FEE: el 3 Q���tX n Commercial [Residential 6 C -t J(1 Building Owner �+,� Name: g ax: (V Phone: s- d q 7_Q d vti'D t--,, ,Q l /fPU Address 3.D 1 l U 6.. .�� City: S�%n fi r --.P IIP.i� State: 11�A Zip: Qr 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 Ice and/or Coffee maker, hose bib, steamer proofer, carbonator, swamp cooler WATER USING DEVICE 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 Water piping, drainage or vent piping Other than atmospheric type vacuum breakers• REPAIR OR ALTERATION ATMOSPHERIC TYPE VACUUM BREAKER BACK FLOW PROTECTIVE DEVICE MEDICAL GAS INCEPTORS 1765 -V -1I, I"vvi A (n7�n rr ► 'Ci 01 I DCASH ❑ CHECK ❑ VISA 0 MC Card# SIGNATURE: EXPIRES: VIN: CURRENT FEES AVAILABLE AT: http://www.spokanevalley.ore/ under the quick links for Forms, Master Fee Schedule. http://www.spokanevalley.org/uploads/Community Development/Documents/Forms/Building/Plumb ingPermi tApplication040309. doc