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2012, 04-25 Permit App: BLD-2012-0475 Plumbing Fixtures(Spokane „i,,i�Valley� 11 iUs n Sprague Ave, uite u -.s Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 pennitcenter c(�,spokanevalley.org Community Development Plumbing Permit Application I q<� Sr l/ �o SITE ADDRESS: I PEKM!1NUMBJ✓K: /�5tet Z `1-`t1 PERMIT FEE: n Commercial n Residential Building Owner Zola Name: Phone: Fax: Address: / 9A --/J 3 ,06/& City: State: Zip: Contractor �Ci ,�//: (/' t of I/�'� Name: Phone:/— 327 33/ Fax: 7/4(//* < /r Address: as— iT- City: �—� State: 0 .. Zip:9/6/.9c— Q 9 �< License License No: FR4 - p P / L•r City Business Contact/Project Manager: Name: Phone: # OF UNITS PLUMBING FIXTURE ON A TRAP TOILETS URINALS TUBS SHOWERS (per trap) Lav/Basins, Bar, Floor, Kitchen, Laundry, Utility, Janitor, Photo, X-ray, Food, SINKS Prep/Culinary Meat DISHWASHER CLOTHES WASHER / GARBAGE DISPOSAL WATER SOFTNER FLOOR DRAIN ROOF DRAIN/OVERFLOW DRAINS Area, Case, Coil, Trench, Condensate FOUNTAIN, DRINKING WATER PIPING/DRAIN-IN WASTE Installation, Alterations, Repair, Reversals WATER USING DEVICE PRIVATE SEWAGE DISPOSAL SYSTEM Ice and/or Coffee maker, hose bib, steamer proofer, carbonator, swamp cooler WATER HEATER INDUSTRIAL WASTE PRETREATEMENT INCEPTORS If Gas, See Mechanical REPAIR OR ALTERATION Including traps, vents except kitchen type grease interceptors functioning as fixture traps ATMOSPHERIC TYPE VACUUM BREAKER BACK FLOW PROTECTIVE DEVICE Water piping, drainage or vent piping Other than atmospheric type vacuum breakers MEDICAL GAS INCEPTORS ['CASH 0 CHECK 0 VISA 0 MC EXPIRES: Card# VIN: SIGNATURE: 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. doc