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2014, 09-17 Permit App: BLD-2014-2222 Plumbing FixturesCommunity Development Permit Center 11703 E Sprague Ave, Suite B-3 Spokane Valley, WA 99206 PHONE: (509) 720-5240 FAX: (509) 688-0037 Plumbing Permit Application D Commercial 1 Residential SITE ADDRESS: 1 nzi c. Bvetuze, Building Owner Name: . Phone: SI{ /- (kJ ,...6‘ 07 Fax: Address: "1944 5.t,v . (4, e1 3 ti IttteAto 0 City: Atdr,,N,Q4 State: og s Zip: /77 Contractor Name:tr.; Die L plum 61,1v Phone: .2 bs_ bei i _ 6 z r7 3 Fax: Address: . i , / tq'i5City: *7,4 State: 1-- r, Zip: s,3 a35 License No: 662 G71.67 z2_ City Business Lic: Contact/Project Manager: Name: m, -t. try\ our,i_. Phone: # 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 I 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 i WATER USING DEVICE Ice and/or Coffee maker, hose bib, steamer proofer, carbonator, swamp coder 3 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 Signature CURRENT FEES AVAILABLE AT: http://www.spokanevallev.oro/ under the quick links for Forms, Master Fee Schedule.