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2015, 06-01 Permit App: BLD-2015-1260 Sewer Reversal
S°jjokane .000Valley Community Development Permit Center 11703 E Sprague Ave. Suite B-3 Spokane Valley. WA 99206 PrOj'act PHONE: (509) 720-5240 FAX: (509) 688-0037 dential -0 JUN 0 1 'Zino RMIj FEE: q SITE ADDRESS: /33 / / , •` C�`'/C ce,e, r'SV PERMIT CH i`!TER �/ l�It' Sub , 7',/7 Building Owner L_..-_.-.___.. Name: ,re,OrQ � Phone: 9� r _O�� Fax. / [ Address. .�/n.a City: State: //�� Zip: C l�'�•/ Contractor Name: Larry Miller Excavating, Inc. Phone: 509-926-1200 Fax: 509-922-5010 Address: 7117 E Rutter Ave City: Spokane Valley State: WA Zip: 99212 License No: LARRYME878NT City Business Lic: Contact/Project Manager: Name: Larry Miller Phone: 509-218-3335 # 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 NATER PIPING/DRAIN-IN WASTE �J !4 Pru/K Installation. Alterations. Repair. eversal J e -We V / WATER USING DEVICE Ice and/or Coffee maker, hose bib. steamer proofer, carbonatorswamp 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 1 INCEPTORS Signature CURRENT FEES AVAILABLE AT: http:!!www.spokanevallev.orgi under the quick links for Forms. Master Fee Schedule. Permit Center 117031: Sprague Ave, Suite B.3 Spokane Val . A 99206 (5 )688-0037 permit cnleragot kanev CY•u[�L Community Development Plumbing Permit Application /11 SITE ADDRESS: Ilulldiug Owner Name: 4/R. -19 Address: 0 Contractor Name: j A)71 777 Address: f L0 a_I 0 1rd 1-."y License No' AzrrE ' AVM � CooteetfProJect Manager: Name: V l '°N iWvC17:6 �'SIOZl 'unr_aui!± pania0aa PERMIT FEE: Phone: — Fax: State: Zip: OA:: Phone: # OF UNITS SHOWERS (per trap) SINKS DISHWASHER CLOTHES WASHER GARBAGE DISPOSAL WATER SOFTNER FLOOR DRAIN Lav/Basins, Bar, Floor, Kitchen. Laundry, Utility, Janitor, Photo, X-ray, Food, Prep/Cullnary Meat • Area Case Coil Trench Condensate ROOF DRAIN/OVERFLOW DRAINS FOUNTAIN, DRINKING WATER PIPING/DRAIN-IN WASTE WATER USING DEVICE PRIVATE SEWAGE DISPOSAL SYSTEM _WATER HEATER INDUSTRIAL WASTE PRETREATEMENT INCEPTORS REPAIR OR ALTERATION installation, Alterations, Repair, Reversal Ice andior Coffee maker, hoae bib, steamer proofer, carbonator, swamp cooler ATMOSPHERIC TYPE VACUUM BREAKER BACK FLOW PROTECTIVE DEVICE _ Other than atmospheric tike vacuum If Gas, See Mec hamcai Including traps, vents exce Water rease interce tore functlonin as fixture tra • s MEDICAL GAS INCEPTORS ❑CASH ❑ CHECK 14VISA Q MC EXPIRES: Card# VIN' SIGNATURE: CURRENT FEES AVAILABLE AT: h :pvwvw, okaneval -er / under the quick links for Forms, Master Fee Schedule- http://www. spoloinevalley.org/uplott&Community Development/Ducwncnis/Forms/Building/PlumbingPermitApplicaaon040309.doe 7n /70 7C1HJ C11.ITQI.Ifl-1J fT71 Tklrl _ QC.C.QoTTPC.C.rAC QC : T7 CTA7 /T/CIA