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2011, 04-26 Permit App: 11001064 PipingSpokan e� „Walley. Permit Center 11703 E Sprague Ave, Suite B-3 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 permitcenternspokanevalley. org Community Development Plumbing Permit Application PERMIT NUMBER: \ —� ()CA PERMIT FEE: LVS— SITE ADDRESS: 5 i O N S i - n Commercial )4Residential Building Owner Name: Phone: Fax: Address: City: State: Zip: Contractor .. Name.Pone: Fax: one: atm �v,r-r �t gar Pl.�..•�t� &12.40A 0 City: State: Zip: License No: City Business Lie: Contact/Project Manager: Name: —I/0R rNC Phone: c vi_ 5 --Nb- 1 # 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 ASH ❑ CHECK ❑ VISA ID MC Card# SIGNATURE: EXPIRES: VIN: CURRENT FEES AVAILABLE AT: http://www.spokanevalley.orq/ under the quick links for Forms, Master Fee Schedule. http://wwwspokaneval ley.org/uploads/Communily_Development/Documen W Forms/Bu i Iding/PlumbingPermitAppl ication040309. doe