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2011, 07-05 Permit App: 11001980 Plumbing FixturesPermit Center Sp®baQ7 "r 11703 E Sprague Ave, Suite B-3 PERMIT NUMBER: ne Spokane Valley, WA 99206 Va11e�7� (509)688-0036 FAX: (509)688-0037 ' PERMIT FEE: germitcenter2spokanevalley.org f � Community Development Plumbing Permit Application / ❑ Commercial Residential SITE ADDRESS: _N �F� 7 �L G Building Owner _ Name:N O� _C� t Phone:5� 9� a� Fax: Address: L11 3 6 "LL "9 City: State:11.1,1 Zip: of g�,6;2 Contractor Name: Phone: Fax: Address: City: State: Zip: License No: City Business Lic: Contact/Project Manager: - 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 Prep/CulinaryMeat 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 proofer, carbonator, swamp cooler PRIVATE SEWAGE DISPOSAL SYSTEM WATER HEATER If Gas, See Mechanical INDUSTRIAL WASTE PRETREATEMENT INCEPTORS Including traps, vents except kitchen a 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 ❑ CHECK ❑ VISA ❑ MC EXPIRES: Card# VIN: SIGNATURE: CURRENT FEES AVAILABLE AT: http://www.spokanevalley.org under the quick links for Forms, Master Fee Schedule. http://www. spokanevalley.org/uploads/Community_pevelopment/Documents/Forms/Building/Plumb ingPermitAppl ication04O309. doe