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2013, 04-18 Permit App: BLD-2013-0683 Plumbing FixturesPermit Centex 11703 E Sprague Ave, Suite B-3 Spokane Valley, WA 99206 (509)688-0036 FAX (509)688-0037 peonitcenter@spokanevallev.org Community Development Plumbing Permit Application PERMIT NUMBER: PERMIT FEE: ❑ Commercial gResidential SITE ADDRESS: / % q t� %C. E , or, 77 OA ye ❑CASH ❑ CHECK ❑ VISA ❑ MC Card# SIGNATURE: EXPIRES: VIN: APR F 3 CSV �r?` :7: ENTER CURRENT FEES AVAILABLE AT: http://www.spokanevallev.orq/ under the quick links for Forms, Master Fee Schedule. Building Owner Name: X r(kr;,,,A U A.. ),yam - Phone: if ei, 3_ f r al O Fax: Address: fC- K� e City: S e, Kt j/ rL x State: pe /,q Zip: / re,/ 6, r V , / Contractor Name: Lary , Cr Ex/icva't"1 hg Phone: €r14.. ia Fax (IAA '5Og0 I}}y j ` Address: 7117 El R -ec A Ve City: . Y sate: wA Zip: iciA i4 License No: LARRY 1111E 91 tf D R City Bush Lie: Contact/Project Manager: Name: Lac, rvadj. C r Phone: a i (. 3335 # 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, Cod, Trench, Condensate ROOF DRAIN/OVERFLOW DRAINS FOUNTAIN, DRINKING Pr" WATER PIPING/DRAIN-IN WASTE 457/49.arGt I iNnstallation, Alterations, Repair, Reversals $ e Wt r / WATER USING DEVICE Ice and/or Coffee maker, hose bib, steamer [rimier, carbonator, swamp cooler PRIVATE SEWAGE DISPOSAL SYSTEM WATER HEATER If Gas, See Mechanical INDUSTRIAL WASTE PRETREATEMENT INCEPTORS Including traps, vents except kitchen type lease 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 Pro;Lct B._ 63 ❑CASH ❑ CHECK ❑ VISA ❑ MC Card# SIGNATURE: EXPIRES: VIN: APR F 3 CSV �r?` :7: ENTER CURRENT FEES AVAILABLE AT: http://www.spokanevallev.orq/ under the quick links for Forms, Master Fee Schedule.