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2013, 06-05 Permit App: BLD-2013-1041 Plumbing FixturesSif&cane Permit Center 11703 E Sprague Ave, Suite B-3 Spokane Valley, WA 99206 (509)688-0036 FAX (509)688-0037 permitcenter@spokanevallev-ora Community Development Plumbing Permit Application SITE ADDRESS: �� l j ✓ 'r- /f S C OtAJ -(4,11" • 1011 PERMIT NUMBER: PERMIT FEE: * L(3.00 0 Commercial gResidential Building Owner Name: C%/i—($ /1 /*i1 -/'t- Phone: 1. .02.y7i Fax Address: SRS^-, e_ City , 5300, /4.4( e y State: Zip: Contractor /y� Name: r r I 1 c Exp �Q �► 11� Phone: l� r1�'P °" o Fax (IAA _50i0 Address: 711 ! ! / w++er A is Ct' , VL„ State: w A H Zip: 9l A l A License No: City Busii Lie: 1 Contact/Project Manager: NamC: L.arr / in i 1 Ler : a it - 333 # OF UNITS PLUMBING FIXTURE ON A TRAP TOILETS URINALS TUBS SHOWERS (per trap) SINKS DISHWASHER Lav/Basins, Bar, Floor, Krtchen, Laundry, Utility, Janitor, Photo, X-ray, Food, Prep/Cufinary Meat CLOTHES WASHER GARBAGE DISPOSAL WATER SOFTNER FLOOR DRAIN Area, Case, Coil, Trench, Condensate ROOF DRAIN/OVERFLOW DRAINS FOUNTAIN, DRINKING WATER PIPING/DRAIN-IN WASTE WATER USING DEVICE I5 4 PP'I1 l K&Instaftation, Alterations, Repair, Reversals ,j a.-le:re-1— PRIVATE SEWAGE DISPOSAL SYSTEM Ice and/or Coffee maker, hose bib, steamer proofer, carbonator, swamp cooler ( WATER HEATER INDUSTRIAL WASTE PRETREATMENT INCEPTORS If Gas, See Mechanical REPAIR OR ALTERATION Includtmg 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 ❑ CHECK 0 VISA 0 MC EXPIRES: Card# VIN: SIGNATURE: CURRENT FEES AVAILABLE AT: httpJ/www.spokanevafev.ory/ under the quick links for Forms, Master Fee Schedule.