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2012, 12-17 Permit App: BLD-2012-2277 Plumbing Fixtures \ Permit Center ip i®kale 11703 E Sprague Ave,Suite B-3 Spokane Val WA 99206 PERMIT NUMBER: Valley' (509)688-003( X:(509)688-0037 ,PERMIT FEE: permitcenter(aspukanevalley.org Community Development Plumbing Permit Application n Commercial /`// tree L / / / � Residential SITE ADDRESS: / 6 7 e g �f� L/lV 6/f DL��� ✓s< ,kG. Building Owner (� Name: J'e fi • tJu 1-/t i/e Phone: Eer_ c/7 Fax: Address: //0fl'd � Lam/ City 977 State: jJ/¢ c,�Zip: I Tos..7 Contractor if/4—�/�_ / Name: �/ Phone: Fax: Address: City: State: Zip: License No: City Business Lic: Contact/Project Manager: Name: Phone: #OF UNITS PLUMBING FIXTURE ON A TRAP TOILETS URINALS TUBS • SHOWERS(per trap) Lay/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 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 Project # l —( —2 z ❑CASH ID CHECK El VISA ❑MC EXPIRES: WED Card# VIN: EC SIG ' .� : 12012 /1- CA f CSV PERMIT CENTER SUS # REV. # CURRENT FEES AVAILABLE AT:http://www.spokanevalley.orq/under the quick links for Forms,Master Fee Schedu e. http://www.spokanevalley.org/uploads/Community Development/Documents/Forms/Building/PlumbingPermitApplication040309.doc