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2008, 11-10 Permit App: 08004440 Cross Connect DeviceRECEIVED 11/07/2008 10:51 5096880037 11/07/2008 10:49 5094824310 DEC YARD CARE Permit Center 117 11703 E Sprague Ave, Suite R.3 S'�ior'irane cot:`L,j7 ,,,_spfl Spokane Valley, WA 99206 Ydlle .,YORCYQIE09)688-On37 Community Development Plumbing Permit Application SITE ADDRESS: _ l i !rl I I C in A ❑ Commercial SV PERMIT CEMTERFR PAGE 02/04 Residential • IIO11 1IV)(A1 IL-- 11,.-%. Building (honer p Name• RE -0 en ActA l e Phone: Fax State. Zip Addre,s ttQ.11 L Irpuirtejt-AC&. aa. biatlyzatiks Contractor /1 1I j} Name 40 YMCAaUare -�/,, Phone: Z/jj'ai -C3CS City, . r6 `, ra)C 1� /-, SLMe'� J��j /-. - 20 Zip Is,.4.. Address: IR1/0G1�7 License No. rc yr t`, 1a Yc ^--�--�L City Bust l,lel Contact Name: 1 / er14- Phone 21' l —r —94 S 2 3 DESCRIPTON OF WORK TOILETS WATER CLOSET BIDETS URINALS TUBS 4 5 SHOWERS (PER TRAP) SINKS 0 B 0 11 17. 13 14 15 16 17 18 9 20 21 22 GARBAGE DISPOSAL WATER SOFTENER ELECTRIC HOT WATER TANK FLOOR DRAINS ROOF DRAINS/OVERFLOW GRAINS FOUNTAINS, DRINKING WATER PIPING/DRAIN-IN WASTE, VENT, PLUMBING, REVERSAL SEWAGE EJECTOR WATER USING DEVICE CROSS CONNECTION DEVICE INTERCEPTORS EDICAL GAS Igor oUIIPU MISCEL NEOUS PLUMBING PIXTURE RIVATE SEWAGE DISPOSAL/SYS INOUSTRIAL WASTE INTERCEPTOR BATH, STALL ON -SPE BUILT LAVSIBASINS, BAR. FLOOR, KITCHEN, LAUNDRY. UTILITY, JANITOR. PHOTO, X-RAY, FOOD, PREP/CULINARY MEAT NOTE IF GAS. SEE MECHANICAL AREA, CASE, COIL, TRENCH, CONDENSATE TALLATION, ALTERATION, REPAIR. REVERSALS GRINDER SUMP PUMP ICE AN/OR COFFEE MAKER, HOSE BIB, STEAMER ?ROOFER, CARBONATOR, SWAMP COOLER VACUUM BREAK E.R, CHECK VALVE, AND R P B P D• FOR: VATS, TANKS, BOILERS GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK NITROUS, OXYGEN OF UNITS X COST 50,00 X 36,00 X 00 x 56.00 8 00 % S000 METHOD OF PAYMENT: DCASH ❑ CHECK 0 VISA C$rd# AUTHORIZED SIGNATURE: REVISED 11/26/0$ EXPIRES: VIN. SG 00 38 Co 20,00 31500 SUBTOTAL IOTA AMOUNT U7 00 PROCESSING FEE TOTAL PERMIT FEE DUE: 535.00 444/1,00