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2014, 05-01 Permit App: BLD-2014-0928 Plumbing Fixtures - Permit Center 3 �+ t ,r.;"RP(20(4--Q qts 11703 E Sprague Ave Stfite B 3 PERMIT NUMBER: Spokane Valley,PYA 99206 t_ (509)688-0036 fAX.(509)688-0037` r {,. # p itcenter@soicanevallev.org204 PERMIT FEE: Community Development Plumbing Permit Application L Commercial j Residential ' e Q SITE ADDRESS: 1,2 / (/�j�+^'" � / X� Building Owner t r {{ Name: f """"""^.-^ -- -- -- p LI Phone. /z..L '' f S Fax 4 Addre I i t Li&UPI 300 C't'., [�.+'jtl o VA-arilState--RA -RZip: 'f G li; contr00r Name' JUL ri tt Phone-AA r p /, ) v't f t L 't d. Fax .', ' d' p Address" v i� �%� 1Cir t'l ,e L,' � fr Ctty4 tt� '< State: / License No: s p2.4711_742) C. 2.ip �7 >r'� 'l �+—���Ln. City Business Lie: Contact/Project : Manager: ? } Nit j Phone. 11 c� PLUMBING FIXTURE ON A TRAP #OF UNITS TOILETS /J URINALS TUBS SHOWERS(per trap) SINKS Lav/Basins,Bar,Floor,Kitchen,Laundry,Utility,Janitor,Photo,X-ray,Food, DISHWASHER Prep/Culinary Meal `3 CLOTHES WASHER GARBAGE DISPOSAL WATER SOFTNER FLOOR DRAIN Area,Case,Coil,Trench,Condensate f' ROOF DRAIN/OVERFLOW DRAINS FOUNTAIN,DRINKING WATER PIPING/0 RAIN-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 INDUSTRIAL WASTE PRETREATEMENT If Gas,See Mechanical 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 SACK FLOW PROTECTIVE DEVICE Other than atmospheric type vacuum breakers MEDICAL GAS INCEPTORS OCASH 0 CHECK 0 VISA 0 MC EXPIRES. Card# VIN: SIGNATURE: P\Community Development\02 Administration\03 Forms-Official Versions\Permit Center\Plumbing Permit Application 04-03-09 dg doc