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2010, 04-29 Permit App: 10001203 Plumbing FixturesSine „" Ualley. Permit Center 11703 E Sprague Ave, Suite B-3 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 permitcenteraa spokanevallev.orr Community Development Plumbing Permit Application (04?e PERMIT NUMBER: PERMIT FEE: n Commercialesidential SITE ADDRESS: g&/c E. 3? tl/0(D Building Owner .. �/ U1 / � Name: Phone: Fax: qpr,���--5993 �j�j-�y �,,//T �y�y Address:5b /5`�i[ L r'L Up city3 t� 94�4y State:////1 Zip9,9:a. v '.:.r .. •:.. .'Contractor -yy"����jj .Name: / Phone. _,/� Fax: 12113 f 0/7C GJ( G7hia% Address: r{,#.t,07 `1x 41() City. f4 vq'�Iy State:ta��/ Zip. 2F� v �(���/to-5(r) License No: City X nngq qT Ci Business Lic. 6,0/ - 356-C / Contact/Project Manager.'::__ ".. .:' „�. .- -.: ..... :. ...-: p�ryry,�,, �J Name: t eiv / 6 8 1,5/e. (; Phone:... 9 g/ / 6, .L1 ,' #OF UNITS PLUMBING FIXTURE ON A TRAP OLi _, 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 Installation, Alterations, Repair, Reversals WATER USING DEVICE Ice and/or Coffee maker, hose bib, steamer prooter, 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 UCASH HECK 0 VISA 0 MC EXPIRES: Card# VIN: SIGNATURE: CURRENT FEES AVAILABLE AT: http://www.spokanevalley.org/ under the quick links for Forms, Master Fee Schedule. http://wwwspokanevalley. org/uploads/Community_Developmen VDocumenis/Forms/Building/Pl umb ingPermitAppl ication040309.doe