2015, 01-29 Permit App: BLD-2015-0164 Sewer Reversal Community Development
Permit Center •
11703 E Sprague Ave,Suite B-3
`� '^ Spokane Valley,WA 99206
YQlky PHONE: (509)720-5240
FAX: (509)688-0037
PERMIT FEE:
Plumbing Permit Application ❑ CommercialResidential
SITE ADDRESS: 769 ea 3 E l/dLAG
Building Owner
Name: /AiIQ
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myPhone: 7 „95--/ - Fax:
Address:
/+'a� g ,q e 23 /re City: (57/4,O Ualker State: 14,7X Zip:7%2
Contractor
Name: Larry Miller Excavating, Inc. Phone: 926-1200 Fax: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:218-3335
#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
ROOF DRAIN/OVERFLOW DRAINS
FOUNTAIN,DRINKING
—*WATER PIPING/DRAIN-IN WASTE Installation,Alterations,Repair,Reversals SQ K/e r. I
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
Signature .1.0
RENT F-`'AV•BLE AT: http://www.spokanevalley. rq/under e quick li , - -- -•--
Project #iS -b901S -QI(aq
RECEIVED
JAN 29 2015
CSV PERMIT CENTER
SUB # I REV. # (