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2012, 03-14 Permit App: BLD-2012-0161 Plumbing Fixtures Permit Center / to`r01"1414144111 11703 E Sprague Ave,Suite B-3 PERMIT NUMBER: 61cC -! z -(b Spokane Valley,WA 99206 ]{�- (509)688-0036 FAX:(509)688-0037 PERMIT FEE: I permitcenternsnokanevalley.org T� Community Development Plumbing Permit Application ❑ Commercial n Residential SITE ADDRESS: 16/21 E 10TH Building Owner Name: Phone: 879_3420 Fax: Address: City: State: Zip: Contractor END PLUMBING �//�� Name: 879-3420 Phone:, Z0 W *1:7Address: 3309 N FOWLER City: MILLWOOD V State: WA Zip: License No: City Business Lie: Contact/Project Manager. Name: Phone: 879_3420 #OF UNITS PLUMBING FIXTURE ON A TRAP TOILETS 3 URINALS 0 TUBS 2 SHOWERS(per trap) 1 Lay/Basins,Bar,Floor,Kitchen,Laundry,Utility,Janitor,Photo,X-ray,Food, SINKS Prep/Culinary Meat 4 DISHWASHER 1 CLOTHES WASHER 1 GARBAGE DISPOSAL 1 WATER SOFTNER 0 FLOOR DRAIN Area,Case,Coil,Trench,Condensate 1 ROOF DRAIN/OVERFLOW DRAINS 0 FOUNTAIN,DRINKING 0 WATER PIPING/DRAIN-IN WASTE Installation,Alterations,Repair,Reversals 0 WATER USING DEVICE Ice and/or Coffee maker,hose bib,steamer proofer,carbonator,swamp coder 3 PRIVATE SEWAGE DISPOSAL SYSTEM 0 WATER HEATER If Gas,SMechaniI) INDUSTRIAL WASTE PRETREATEMENT INCEPTORS Including traps,vents except kitchen type grease interceptors functioning as fixture traps 0 REPAIR OR ALTERATION Water piping,drainage or vent piping 0 ATMOSPHERIC TYPE VACUUM BREAKER 0 BACK FLOW PROTECTIVE DEVICE Other than atmospheric type vacuum breakers MEDICAL GAS 0 INCEPTORS 0 ❑CASH 0 CHECK 0 VISA 0 MC EXPIRES: Card# VIN: SIGNATURE: F;` P:\Community Development\02 Administration\03 Forms-Official Versions\Permit Center\Plumbing Permit L{a ----- i SUUR1i11tt! tf