2009, 09-22 Permit App: 09003041 Floor Drain Permit Center
CITYa 11703 E Sprague Ave,Suite B-3 PERMIT NUMBER: `-S014
Spokane Valley,WA 99206
(509)688-0036 FAX:(509)688-0037 PERMIT FEE:
permitcenter(ii)spokanevallev.org
Community Development
Plumbing Permit Appl}ication ' l ❑ Commercial ® Residential
SITE ADDRESS: _ ( [OiY if -c :414 • ,I�, . Q r ') Oetitcrj (. P1
Building Owner
Name:MARC LIPPINCOTT Phone:509-994-8135 Fax:
Address:2411 S CANYONE WOODS LANE#301 City:SPOKANE State:WA Zip:99224
Contractor
Name:TIMBERED RIDGE CUSTOM HOMES Phone:208-772-4749 Fax:208-762-6376
Address: 10063 NAVION DR. City:HAYDEN State:ID Zip:83835
License No:TIMBERC910J4 City Business Lic:602916803
Contact/Project Manager:
Name:JEREMY TRIPP Phone:208-8184843
#OF UNITS
PLUMBING FIXTURE ON A TRAP
TOILETS
URINALS
TUBS
SHOWERS(per trap)
Lav/Basins,Bar,Floor,Kitchen,Laundry,Utility,Janitor,Photo,X-ray,Food,
SINKS Prep/Culinary Meat
DISHWASHER
CLOTHES WASHER
GARBAGE DISPOSAL
WATER SOFTNER
FLOOR DRAIN Area,Case,Coil,Trench,Condensate 1
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
OCASH ®CHECK MI VISA 0 MC EXPIRES:
Card# VIN:
SIGNATURE:
CURRENT FEES AVAILABLE AT:http://www.spokanevallev.orq/under the quick links for Forms,Master Fee Schedule.