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2011, 08-29 Permit App: 11002641 Plumbing Fixturesspoon ' .0%0Valley. Permit Uenter 11703 E Sprague Ave, Suite B-3 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 permitcenter@spokanevalley.org Community Development Plumbing Permit Application SITE ADDRESS: 6 /141 ss/ 0 PERMIT NUMBER: 1 — z4 t—t' PERMIT FEE: 1_",' ' n Commercial 1/5 /�Z_ o3z7 esidential Building Owner Name: ���/ /3 z s Phone: , 69 —5333] Fax: /20 Address: '7 O 2 Z, M! S i r U <CJ City: Sic) C} 1Ui ✓L.LA te: 6....4.,ji6A_Zip: 9- c �l 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 4' SHOWERS (per trap) 3 SINKS Lav/Basins, Bar, Floor, Kitchen, Laundry, Utility, Janitor, Photo, X-ray, Food, Prep/Culinary Meat ' j DISHWASHER % CLOTHES WASHER GARBAGE DISPOSAL WATER SOFTNER — FLOOR DRAIN Area, Case, Coil, Trench, Condensate d- / 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 ' 7 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 ❑CASH ❑ CHECK ❑ VISA ❑ 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.doe