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2010, 02-05 Permit App: 10000311 Plumbing Fixtures• Spokane cos:Ofey. .1 Permit Censer 11703 E Sprague Ave, Suite B-3 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 oermitecnler a sookanevalley ore Community Development Plumbing Permit Application PERMIT NUMBER: l PERMIT FEE: (i Q cr Commercial 1 `'Residential SITE ADDRESS: 9/d - 92 -o - S b y 5rtPbKo-.4 Q(l� , tA)a, Building Owner __ Phone7r'�119 2�/% L/ (ci� Fax: U' Q7 a9 al Y Name r/xi A -f i inn% /(9 L� '�� re / q Address: 1).No 4 1",..701",..70C f ore ) CG�y re-f�^ City:Ai ICY I''Ge�l LK Stale: L et__ Zip- Zip- 9 qp,y g 1 or ' - _ Contract,...: °- __ -. �'�",_ _., .r' . , - .. - _ - _ q Name: /-. O M �xj- `o'S p -r r rj 2 q1 2 ) Phone: / c9 O o' 2 Fax ¶o 9 299 y ((o I C 93 City. M 'met „co_ 1 t c State: � L''` Zip 41 5 O `Z 2 Address: a, o qv) y LA) M et C) a_t_e �� License No: L.70 - Nr Al! 1 r 'C ----c Z City Business Lie Contact/Project Manager. _ _ -___ - ._ _ _ _ _._ .._ .,. __ _ _. C� Name AA 0,r( r11 YLJ, Phone: 5'(9 `j �( QJ O o d 3 - # OF UNITS PLUMBING FIXTURE ON A TRAP TOILETS //�l URINALS /dam p TUBS 1 SHOWERS (per trap) / SINKS Lav/Basins, Bar, Floor, Kitchen, Laundry, Utridy, Janitor, Photo, X-ray, Food, Prep/Culinary Meat DISHWASHER 1 CLOTHES WASHER 1 GARBAGE DISPOSAL 1 WATER SOFTNER 0 FLOOR DRAIN Area, Case, Coil, Trench, Condensate ROOF DRAIN/OVERFLOW DRAINS FOUNTAIN, DRINKING re— WATER PIPING/DRAIN-IN WASTE Installation, Alterations, Repair, Reversals -t<9--- WATER USING DEVICE Ice and/or Coffee maker, hose bib, steamer proofer, carbonator, swamp cooler `9— PRIVATE SEWAGE DISPOSAL SYSTEM WATER HEATER If Gas, See Mechanical 1 INDUSTRIAL WASTE PRETREATEMENT INCEPTORS Including traps, vents except kitchen type grease interceptors functioning as fixture traps Q REPAIR OR ALTERATION Water piping, drainage or vent piping ATMOSPHERIC TYPE VACUUM BREAKER BACK FLOW PROTECTIVE DEVICE Other than atmospheric type vacuum breakers ,C � `� MEDICAL GAS ' O INCEPTORS - - ❑CASH ❑ CHECK 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://wwwspokanevalley org/uploads/Community Development/Documents/Forms/Building/PlumbingPermitApplication040309 doe'