2010, 05-26 Permit App: 10001525 Sewer ReversalPermit Center
'lane 11703 E Sprague Ave, Suite B-3
t.J�ll/ss 7,�- Spokane Valley, WA 99206
V ' (509)688-0036 FAX: (509)688-0037
permitcenterrulspokanevalley org
PERMIT NUMBER: ( O — t Sa
PERMIT FEE:
Community Development
Plumbing Permit Application n Commercial
® Residential
SITE ADDRESS:
s-oS-SD7 /V, Zi Batt
Building Owner
Name: f la"
I / vPhone: Fax:
✓
Address �t' City: State. Zip.
Contractor
Name: TLC Construction Phone: 509-456-3687 Fax:
Address: 9006 S. Hayford Rd. City: Cheney State: WA Zip: 99004
License No: TLCCO14I07M6 City Business Lic:
Contact/Project Manager:
Name: Terry Courchaine Phone: 509-456-3687
# OF UNITS
PLUMBING FIXTURE ON A TRAP
TOILETS
URINALS
TUBS
SHOWERS (per trap)
SINKS
Lav/Basins, Bar, Floor, Kitchen. Laundry, U6hty, 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
11 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
C36ASH 0 CHECK ❑ VISA 0 MC EXPIRES:
Card# VIN
SIGNATURE:
CURRENT FEES AVAILABLE AT: http:/Avww.spokanevallev orq/ under the quick links for Forms, Master Fee Schedule.
C:\Documents and Settings\UserVNy Documents \ PlumbingPennitApplication040309.doc