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2014, 03-24 Permit App: BLD-2014-0559 Sewer ReversaleissoNt... Permit Center 11703 E Sprague Ave, Suite 8-3 Spokane Valley, WA 99206 (509)688-0036 FAX (509)688-0037 permitcenter@spokanevallcV.org Community Development Plumbing Permit Application SITE ADDRESS: ;4::1`,FIVFD mAY `i 2014 'EAdeft CENTER ER E: rci Residential Building Owner N ger. peze Phone: of.r...—Ce -°"-r Address: /.2 6%2 3 /iti A.,vv. ‘,...,./ Az.City Ka i(ey State: WA ZiP: 749:/. e g" .1,0 Contractor Name: Lit r , t „( A< i ffee vet.ii_e, Phone: a c.hz a," Fax 11,62..2 - 5 -of 0 state: W'n Address: .7 I ( 7 .c. ,.16.4. tt-er- v eZip: ,4 License No: inewr If itvt e 878 N. 7- City Bu&ess Lic: Contact/Project Manager: Name: Phone: # OF LINTS PLUMBING FIXTURE ON A TRAP TOILETS URINALS TUBS SHOWERS (per trap) SINKS Lav/Basins, Bar, Floor, Kitchen, Laundry, Utifdy, Janitor, Photo, X-ray, Food, Prep/Cufinary Meat DISHWASHER CLOTHES WASHER GARBAGE DISPOSAL WATER SOFTNER FLOOR DRAIN Area, Case, Cod, Trench, Condensate ROOF DRAIN/OVERFLOW DRAINS FOUNTAIN, DRINKING ;k WATER PIPING/DRAIN-IN WASTE 1/17 Pro-ir- Insta�ation, Aiterations, Repai R e. r / WATER USING DEVICE Ice and/or Coffee maker, hose bib, steamer prooter, carbonator, swamp cooler PRIVATE SEWAGE DISPOSAL SYSTEM WATER HEA 1 ER 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 Osing ATMOSPHERIC TYPE VACUUM BREAKER BACK FLOW PROTECTIVE DEVICE Other than atmospheric type vacuum breakers MEDICAL GAS INCEPTORS DCASH 0 CHECK 0 VISA 0 MC Card# SIGNATURE: EXPIRES: VIN: CURRENT FEES AVAILABLE AT: http://vonovv.spokanevalley.orq/ under the quick links for Forms, Master Fee Schedule.