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2012, 09-17 Permit App: BLD-2012-1598 Plumbing Fixturespane -� �j�alley° 11 /Us r Sprague Ave, Jurte is -s Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 permitcenter@spokanevallev.org Community Development Plumbing Permit Application SITEp SITE ADDRESS: D Z / L( / , - Ft 12 l i TT J Building Owner C';4, 1_ (1/i 714 -1 PERMIT NUMBER: '&0 0 - )7 - LS PERMIT FEE: n Commercial n Residential Name:Fax: C l4 le- (. C,i /.6ir--Jo /G Phone: (, ,�` ; , Jz v ^� Address: City: State: Zip: C'c- Contractor \S-, /4 .✓ . :7 /'_- u'A, )) tom. C-/4 X Name: Phone: Fax: Address: City: State: Zip: License No:�f . a ,--_ w (3 2 C � City Business Lic: Contact/Project Manager: Name: Phone: # OF UNITS 'LUMBING 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 Installation, Alterations, Repair, Reversals WATER USING DEVICE Ice and/or Coffee maker, hose bib, steamer proofer, carbonator, swamp cooler WIVATE SEWAGE DISPOSAL SYSTEM ATER HEATER If Gas, See Mechanical DUSTRIAL WASTE PRETREATEMENT CEPTORS Including traps, vents except kitchen type grease interceptors functioning as fixture traps =PAIR OR ALTERATION Water piping, drainage or vent piping MOSPHERIC TYPE VACUUM BREAKER .CK FLOW PROTECTIVE DEVICE Other than atmospheric type vacuum breakers EDICAL GAS ;EPTORS SASH ❑ CHECK ❑ VISA ❑ MC rd# NATURE: EXPIRES: VIN: ;URRENT FEES AVAILABLE AT: http://www.spokanevalley.orq/ under the quick links for Forms, Master Fee Schedule. p://www.spokanevalley.orp_/uploads/Community Development/Documents/Forms/Building/PlumbingPermitApplication040309. doc