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2012, 04-12 Permit App: BLD-2012-0373 Plumbing Fixtures rermit L,enter sj "r 11703 ES r R �pokaIIe Sprague Ave,Suite B-3 PERMIT NUMBER: U 1 - I Z-3 r V�.,*' Spokane Valley,WA 99206 alle ` (509)688-0036 FAX:(509)688-0037 • permitcenter@,spokanevalley.org PERMIT FEE: 53-61%<:7 Community Development Plumbing Permit Application //� ��y n Commercial �Residential SITE ADDRESS: /V-5 6--;(r,6 / l/ (� �/� � Yv /T Building Owner Name: , /� Phone: 't��/� "9��r Fax: Address: • �''�� y /. /-75_ `/ �l) Q�eC1� L ! '� State: ��/1 Zip: 99 ,7.5.7/ Contractor �7 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 • L 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 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 ❑CASH 0 CHECK ®.VISA ❑MC EXPIRES: Card# VIN: SIGNATURE: CURRENT FEES AVAILABLE AT:http://www.spokanevalley.orq/under the quick links for Forms,Master Fee Schedule. http://wwwspokanevalley.org/uploads/Community Development/Documents/Forms/Building/PlumbingPermitApplication040309.doc