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2009, 09-18 Permit App: 09003006 Water PipingSpokane eaValley- , Permit Center 11703 E Sprague Ave, Suite B-3 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 permitcenter( spokanevallev.ore Community Development Plumbing Permit Application PERMIT NUMBER: PERMIT FEE: n Commercialifesidential SITE ADDRESS: 915'D / £ gro c4-� Building Owner {y/G(/�rP' .. G - los-tee/^>- Name: �� �' � Phone: 2.37 _ v6 /7 Fax: / Address: 9s0/ g /3r0 '✓ S City { piae 44/‘ State Sg Y_4 Zip:fn C .;Contractor Se / (�.__, Name: Phone: Fax: Address: City: State: Zip: License No: City Business Lie: .; Contact/Project Manager: 1 Name: Phone: # 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 GARBAGE DISPOSAL WATER SOFTNER FLOOR DRAIN Area, Case, Coil, Trench, Condensate ROOF DRAIN/OVERFLOW DRAINS FOUNTAIN, DRINKING WATER PIPING/DRAIN-IN WASTE D / o L saws Lek " e- Installation, Alterations, Reptt-evert Lek WATER USING DEVICE Ire and/or Coffee maker, hose bib, steamer proofeonator, 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 ❑CASH O. 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://wwwspokaneval ley, org/uploads/Communily_Devel opmenVDocumentc/Fonns/Bui I d ing/PI u mbingPerm itApplication 040309. doc