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2011, 06-01 Permit App: 11001548 Drain ConnectSpokane co:01/211eyr :% • Y Permit Center 11703 E Sprague Ave, Suite B-3 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 permitcenterfaispokanevalley.org Community Development Plumbing Permit Application n� / SITE ADDRESS:��JJli v'//(v h�i�y/X2��P'e 1 /-15/8 q3 PERMIT NUMBER: PERMIT FEE: n Commercial Residential Building Owner j/ r 4 h, S C i U// /7 Name: Phone- Fax: Address: City: State: Zip Contractor Name: /� /�S (d/sogs Phone Fax: �'dG-cjG� Address 7/ /, / 12// City: State Zip License No: / .S e„,0, /7? , City Business Lic: if 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 Meat DISHWASHER CLOTHES WASHER GARBAGE DISPOSAL WATER SOFTNER FLOOR DRAIN Area, Case, Coil, Trench, Condensate ROOF DRAIN/OVERFLOW DRAINS -.------s... FOUNTAIN, DRINKING \ WATER PIPING/DRAIN-IN WASTE Installation, Alterations, Repair, Reversals \\\VVV 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 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 atmosphenc type vacuum breakers MEDICAL GAS INCEPTORS DCASH 0 CHECK ❑ 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://www spokanevalley org/uploads/Community_ Development/Documents/Forms/Building/PlumbingPermitApplication040309 doc