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2012, 02-29 Permit App: BLD-2012-0059 Water Heater40,0 Val ley Permit Center 11703 E Sprague Ave, Suite B-3 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 perm i tcenter r spokaneval ley. ora Community Development Plumbing Permit Application SITE ADDRESS: 1331% E VocK uj ea PERMIT NUMBER: PERMIT FEE: �u n Commercial Residential Building Owner Phone: qqj� .N qC Fax 1 > Name: i', ` I ° a/tit 'Fernv "/ Address: / State: Zip. 1334) b' - flirt f City: ,,, e c/� 7 7��Jv Contractor ` Name:e ` �f Phone: Fax: -1 / ��� ��/�G�o � Address: p5.220n��4`�S City: State: Zip: Ay/lion CL J S�oo�c�n e am_ �9-e�-2 License No: SPoFP 9i /) TZ� City Busi ess Lic: y es- 7 0`�'� s.3-2_____ Contact/Project Manager: Name: Scot– Phone: 9‘7-66 –07 # 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, Coil, Trench, Condensate ROOF DRAIN/OVERFLOW DRAINS FOUNTAIN, DRINKING WATER PIPING/DRAIN-IN WASTE Installation, Alterations, Repair, Reversals WATER USING DEVICE Ice and/or Coffee maker, hose bib, steamer proofer, carbonator, swamp cooler PRIVATE SEWAGE DISPOSAL SYSTEM WATER HEATER If 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 atmospheric type vacuum breakers MEDICAL GAS INCEPTORS ❑CASH ❑ CHECK ❑ VISA ❑ MC Card# SIGNATURE: EXPIRES: VIN: P:\Community Development\02 Administration\03 Forms - Official Versions\Permit Center\Plumbing Permit Application 04-03-09 dg.doc