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2012, 10-18 Permit App: BLD-2012-1858 Plumbing Fixtures 6c_ zaiZ_ Ids Permit Center S'' 17Valley, Sprague Ave,Suite B-3 PERMIT NUMBER: 's Vd�� SpokaneoWA 99206 Y 509 036 FAX:(509)688-0037 PERMIT FEE: Community Development Plumbing Permit pplication r� n Commercial ❑Residential SITE ADDRESS: /„ '6.767 �' .9(/�� Building Owner Name: -Mae° 048 Phone: Fax: Address: /g'o J F City: State: Zip: Contractor jpi,NAL /�'3 L ki g/vG D'C Name: M`n, 414R 5 N,9u Phone: J[ _.220, 39 9 Fax: Address: City: State: Zip: License No: Mmes./imp 0.4/ '?47 City Business Lic: Contact/Project Manager: 27//4//0/v &CGS, (&9i5T ,�1✓C Name: C:1 hl lose/✓ Phone. „sG') #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 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 D CHECK VISA 0 MC EXPIRES: Card# VIN: SIGNATURE: P:\Community Development\02 Administration\03 Forms-Official Versions\Permit Center\Plumbing Permit Application 04-03-09 dg.doc