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2012, 03-21 Permit App: BLD-2012-0204 Plumbing FixturesSilorime Permit Center 11703 E Sprague Ave, Suite B-3 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 pennitcenter a sookanevallev.org Community Development Plumbing Permit Application SITE ADDRESS: 7vz l E Q6a/vE 5.00rAwc PERMIT NUMBER: 6 (c - 2 - ZO PERMIT FEE: / 9 ❑ Commercial %Residential 150/6, 1 ['CASH Card# SIGNATURE: ❑ CHECK K71 VISA ❑ MC EXPIRES: VIN: CURRENT FEES AVAILABLE AT: http://vrowi.spokanevalley.orq/ under the quick links for Forms, Master Fee Schedule. http://wwwspokanevalley.org/up loads/Community_Development/Documents/Fors/Building/PlumbingPermitApplication040309. doc Building Owner Name: Sic �/n Phone: Fax: Address: / 7 Liz. / E /Soave City: 5476jA/c State: /,.//4_ Zip:9,0/6) Contractor Name: 410p/C ACU/I/SiV(t Aav9 nnCC . Phone: 7/0_/35 7 Fax: .. �/ Address: Sox' &cat" City: SI 1uE State: (il//-_ Zip: 5 Z/ 7 License No: City Business Lic: Contact/Project Manager: Name: 042%,//-7 7—/5OMZg Phone: 7/0 ...._/ 357 # OF UNITS PLUMBING FIXTURE ON A TRAP TOILET'S 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 t1 3vitei`h1 Pict n Cprlrj i ['CASH Card# SIGNATURE: ❑ CHECK K71 VISA ❑ MC EXPIRES: VIN: CURRENT FEES AVAILABLE AT: http://vrowi.spokanevalley.orq/ under the quick links for Forms, Master Fee Schedule. http://wwwspokanevalley.org/up loads/Community_Development/Documents/Fors/Building/PlumbingPermitApplication040309. doc