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2012, 08-22 Permit App: BLD-2012-1409 PipingSPO7� rcnmr Uenrer Ra` ne 11703 E Sprague Ave, Suite B-3 ._�Y' q �p� Spokane Valley, WA 99206 rq'aHey (509)688-0036 FAX: (509)688-0037 ermitcenter s okanevalle .or Community Development Plumbing Permit Application SITE ADDRESS: / 0 7 0(T �� O y – O X.G d–O S fF r>a„ PERMIT NUMBER:&0-/Z•/ D PERMIT FEE: 0,!r3-0 Commercial f�f Residential Name: vO -e 6- i"rq--�S/14 t..�� Phone: Fax: Address: SPcoKane Val/ C State: /y fa Zip: Contractor Name: Y, '9 J l t' i -/r c� Phone: 3 L 3 .� Fax: Address: ,70 City: City: State: Zip: License No: S'T rrO S J Ia 8 ci X11.. � City Business Lie: CnotacVProject Manager: Name:{6.r 7lAd5 J�q.rr— Phone: ATMOSPHERIC TYPE VACUUM BREAKER GAS ❑CASH ❑ CHECK ❑ VISA ❑ MC Card# SIGNATURE: EXPIRES: VIN: Other CURRENT FEES AVAILABLE AT: http://�sookanevallev org/ under the quick links for Forms, Master Fee Schedule. http://w .spokanevalley.orgluploads/Commmity_DevelopmentIDocuments/FormsIBuildin91PIumbingPermitApplication040309.doc