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2010, 02-24 Permit App: 10000507 Plumbing FixturesPermit Center 11703 E Sprague Ave, Suite B-3 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 perrnitcenteraspokanevalley.org Community Development Plumbing Permit Application SITE ADDRESS: PERMIT NUMBER: PERMIT FEE: 1 1 Commercial Residential . 4.//t Y a/6 Building Owner Name: S /4,504. F,,, --de Phone: la 7 _ 24 2r-- Fax: N 7— //G/ • <1., Zip: Address: », /' ..r _s..„‘ /„....., City: .k.,., e (41 aif State" Contractor / Name: .1—R t .T_,..t c Phone: z / — Lt 1 0 Fax: ,e-,0 , Address: City: State: Zip: License No: City Business Lic: Contact/Project Manager: Name: Cf-- ti ./-• l're--, Phone: 14 _ # 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 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 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 OCASH DCHECK 0 VISA 0 MC Card# SIGNATURE: EXPIRES: VIN: CURRENT FEES AVAILABLE AT: http://www.spokanevalley.orq/ under the quick links for Forms, Master Fee Schedule. http://vvww.spokanevalley.org/uploads/Community_Development/Documents/Forms/Building/PlumbingPermitApplication040309,doc JRLED Corp P.O. Box 1907 Veradale, WA 99037 2-25-10 RE: Removal of responsibility from permit. City of Spokane Valley, Please remove JRLED Corp from Permit #10000507, as I am no longer the General Contractor on this property at and have no further responsibility for this project. This home is incomplete. I did not apply for this permit in the first place. Thank You, Jerez ager, President Cc' ,1