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2010, 01-28 Permit App: 10000220 Plumbing FixturesSpokane e�``` I*Valleyx Permit Center 11703 E Sprague Ave, Suite B-3 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 permiteenter@spokanevalley.org Community Development Plumbing Permit Application PERMIT NUMBER: PERMIT FEE: Commercial Residential SITE ADDRESS: / L 132. L - �j��'� �✓� Building Owner Name: n 4 ') Phone: Fax: b �` ,� Address: City: State: Zip: Contractor Name: Phone: Fax: Address: /% City: Vzv CI r<sGl z74 A; State: /1v1i Zip 7 ye,.? -7 License No: City Business Lic: Contact/Projeectt Manager: J Name: J e" r p M ✓i Phone: Z i69 (; *-f-c..... 6 # OF UNITS PLUMBING FIXTURE ON A TRAP TOILETS URINALS TUBS I SHOWERS (per trap) 1 SINKS Lav/Basins, Bar, Floor, Kitchen, Laundry, Utility, Janitor, Photo, X-ray, Food, Prep/Culinary Meat al DISHWASHER I CLOTHES WASHER GARBAGE DISPOSAL WATER SOFTNER FLOOR DRAIN Area, Case, Coil, Trench, Condensate I 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 cooler PRIVATE SEWAGE DISPOSAL SYSTEM WATER HEATER If Gas, See Mechanical I 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 I ATMOSPHERIC TYPE VACUUM BREAKER BACK FLOW PROTECTIVE DEVICE Other than atmospheric type vacuum breakers MEDICAL GAS INCEPTORS DCASH ❑ CHECK ❑ VISA ❑ MC Card# SIGNATURE: EXPIRES: VIN: CURRENT FEES AVAILABLE AT: http://www.spokanevalley.orq/ under the quick links for Forms, Master Fee Schedule. http://www.spokanevalley.org/uploads/Community_Development/Documents/Forms/Building/PlumbingPerm itAppl ication040309. doc