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2010, 11-18 Permit App: 10003844 Piping Permit Center �"nQ>J7A�e 11703 E Sprague Ave,Suite B-3 PERMIT NUMBER: Z)% l� Spokane Valley,WA 99206 ��'sValley� (509)688-0036 FAX:(509)688-0037 PERMIT FEE: permitcenter@spokanevalley.org Community Development Plumbing Permit Application Commercial, —1 Residential SITE ADDRESS: /0 Zv Z IG 7 Building Owner Name: 4, Phone: Fax: Address: /0 ZO a E 7 '>, City: State: Zip: Contractor Name: — Phone: ei ocy. ll Fax: Address: "Ti it_1 T_ City: State: Zip: License No: City Business Lic: Contact/Project Manager: Name: X}i r✓t ✓2�tF i RJ4 Phone: L�zc1 #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 ROOF DRAIN/OVERFLOW DRAINS FOUNTAIN,DRINKING WATER PIPING/DRAIN-IN WASTE Installation,Alterations,Repair,Reversals f 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 f4L:PCASH 0 CHECK 0 VISA 0 MC EXPIRES: Card# VIN: SIGNATURE: CURRENT FEES AVAILABLE AT:http://www.spokanevalley.orq/under the quick links for Forms,Master Fee Schedule. http://www.spokanevalley.org/uploads/Community Development/Documents/Forms/Building/PlumbingPermitApplication040309.doc