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2014, 01-02 Permit App: BLD-2014-004 Plumbing FixturesCommunity Development Permit Center Wiliam 11703 E Sprague Ave, Suite 8-3 `�'7 Spokane Valley, WA 99206 V[dlley` PHONE: (509) 720-5240 FAX: (509) 688-0037 TAA Cas `Hipp SLD -a1011-COO Plumbing Permit Application 0 Commercial 0 Residential SITE ADDRESS: PERMIT FEE: Building Owner fl) Q Nk,R. On F -E/1 1. Name: Phone: / Fax: �%S Y1 ,r7 C/ Address: € 9 7 / ti V Q �'f T e �) City: %l /-' V 5Eu2 State: i O Zip: S / Contractor f 1..L.-... 5 -t9 JV S' /p L V m d7 A/4' L -GS Name: Phone: 2 / % _6024 Fax: I� Address: j (2 2n i -7_ of V 1: City: .�'pc' dold—el State: fir/' At Zip: 7 9 co /L License No: ft K 5 � f /1, o r0 3 /J D City Business Lic: Contact/Project Manager: Name: Phone: # UNITS PLUMBING FIXTURE ON ATRAP 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 . DRAIN Area, Case Coil Trench, Condensate FLOOR 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 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 atmospheric type vacuum breakers MEDICAL GAS INCEPTORS Signature 3 JJ��� hVVh 0(3 CL CURRENT FEES AVAILABLE AT: http://www.spokanevallev.orcd under the quick links for.Fo s, MSster.Fee Schedule. t3tUtivtU JAN 02 2014 CSV PERMIT CENTER SUB#I I REV.#