2011, 04-18 Permit App: 11000974 Pipingun,.liLlllc
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Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAN (509)688-0037
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Community Development
Plumbing Permit Application
PERMIT NUNIBER: / I — U—I 7CJ
PERMIT FEE:
Commercial 'Residential
SII E ADDRESS: 73 6 /'r0/t -fret -r y
Building Owner 1
Name Jore ( Ct$/ e r ensPhone Itfit .733f- Fav
r
Address `733 / / C /Wok L9l O pricy -7 City State Zip
Contractor / //
Name r ��" Phone Fax
La N[, /lr[ t (�EY' ( �C4 V4 [Ky �.Z 6' 0200
Address i ( 7 ' E. K� -tr. Aye t City State Zip
7
License No
2/'r « "et g ?r g 0R C itv Business Lic
Contact/Project Manager:
�/ — 1 /—
Name 4 q,//
rr.y , r [ // er Phone 2! 355
# OF UNITS
PLUMBING FIXTURE ON A TRAP
TOILETS
URINALS
TUBS
SHOWERS (per trap)
SINKS
Lav/Basins, Bar, Floor, Kitchen, Laundry, Uhldy, 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, RepairReversals- .St'rVei
/
WATER USING DEVICE
Ice and/or Coffee maker, hose bib. steamer proofer, carbonator, swamp cooler
PRIVATE SEWAGE DISPOSAL SYSTEM
WATER HEATER
It 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
❑CASH ❑ CHECK 0 VISA 0 MC
Card#
SIGNATURE
EXPIRES
VIN
P \Community Development\02 Admims,ral on\(13 Forms - Official Versions \Perm« Center \Plumbing Permit Application 04-03-09 dg doe