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2011, 04-14 Permit App: 11000931 Plumbing FixturesPermit Center De 11703E Sprague Ave, Suite B-3 Spokane Valley, WA 99206 {� Nadler (509)688-0036 FAX: (509)688-0037 permitcenter@spokanevalley.org e Community Development Plumbing Permit Application � SITE ADDRESS: I a, -;ac E. -IJ fk Ori e _ PERMIT NUMBER: PERMIT FEE: n Commercial 3j esidential Building Owner L Name: V Ar ICS 1r(rT4L)c&r ? e 4)6 of t,\Q/^ Phone/ - 617L/ Fax: Cl `I Address: () ) b E (44-k U City: State: Zi SPo�,Art. vq I l.y � q P iti �. t 6 ` Contractor r Q -C i-'( a L c I Ij M(j ,,Thr 11` r Name: m1c11 Te, 111' I'fA -e�P Phone:1S 060 c8 l 7 -eaW 9 Fax: (SO1j aa6 —a3 is 1 1p Address: , U t (1, OiC 1 5 9,-) City: V f o q P State: q Zip: ill 1 0'37 License No: City Business Lic: Oeptin P L q05 IRM f T� Contact/Project Manager: / Name: C. f. r 1 -LS S ( «- l -be 4/111- — Phone: S 0aj 9 s 1- 6 9 7 c,/ •1 # OF UNITS PLUMBING FIXTURE ON A TRAP cr TOILETS a URINALS Ai7 t TUBS 1 SHOWERS (per trap) SINKS Lav/Basins, Bar, Floor, Kitchen, Laundry, Utility, Janitor, Photo, X-ray, Food, Prep/Culinary Meat DISHWASHER ,� / /t//A CLOTHES WASHER I GARBAGE DISPOSAL 1 WATER SOFTNER N/A FLOOR DRAIN Area, Case, Coil, Trench, Condensate 1 ROOF DRAIN/OVERFLOW DRAINS W/A FOUNTAIN, DRINKING NSA WATER PIPING/DRAIN-IN WASTE Installation, Alterations, Repair Reversals I WATER USING DEVICE Ice and/or Coffee maker, hose bib, steamer proofer, carbonator, swamp cooler / A PRIVATE SEWAGE DISPOSAL SYSTEM Ali / A WATER HEATER If Gas, See Mechanical a 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 I ATMOSPHERIC TYPE VACUUM BREAKER BACK FLOW PROTECTIVE DEVICE Other than atmospheric type vacuum breakers / / rt' �14. MEDICAL GAS at' N/A INCEPTORS N / 4 ['CASH 9 CHECK 9 VISA 9 MC Card# SIGNATURE: EXPIRES: VIN: CURRENT FEES AVAILABLE AT: http://www.spokanevalley.orq/ under the quick links for Forms, Master Fee Schedule. http://wwwspokanevalley.org/uploads/Community_Development/Documents/FormsBuilding/PlumbingPermitApplication040309.doc