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2011, 09-07 Permit App: 11002764 Plumbing Fixtures
an it kal<e'\44 Permit Center 1 1703 E Sprague Ave, Suite B-3 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 perm itcenter%it}spokaneva I Iev. ora Community Developmen: Plumbing Permit Application PERMIT NUMBER: 1 (-776 PERMIT FEE: 3 4142—, ❑ Commercial ,Residential SITE ADDRESS: �j ? 2 * «7J , ye Building Owner Name: /11455 s;57°'7Z,,,,t. e Phone: 90„ Cr- Fax: Address: �' 7.21- X- It fa 4 Ye City: S2,mtF , (t" L State: W4' Zip: �90 (� Contractor Name. / c• Phone: Fax: a�°lgl�2 r�,ct�jr CaYf� �•C G�1.1 mea/ �a2�,2 �v o Address: 7 / ( 7 c /l u- (( Cly G . City: 5/0„60,4 a< 1j��„/ State: VA( Zip: r'/'.2 /,2 License No: City Business Lic: Contact/Project Manager: -Name: 4a i^ r' /Fi e`(/e r r Phone: 02 / r.- 3'3 5* # 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 0. 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 JCASH 0 CHECK 0 VISA 0 MC Card# SIGNATURE EXPIRES: VIN r:\Community Development\02 Administration\03 Forms - Official Versions\Permit Center\Plumbing Permit Application 04-03-09 dg.doc