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2010, 02-03 Permit App: 10000274 Water PipingPermit Center 11703 E Sprague Ave, Suite B-3 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 permiteenterespnkanevallev.ory Community jevelopment Plumbing Permit Application 7 SITE ADDRESS: 1 90 (/7 Vh PERMIT NUMBER: (0- PERMIT FEE: 3/3- n Commercial Jay Residential DCASH ❑ CHECK 0 VISA 0 MC Garda SIGNATURE: EXPIRES: VIN: CURREIJT FEES AVAILABLE AT: http:/Avww.spokanevallev.orq/ under the quick links for Forms, Master Fee Schedule. htlpY/www.spokanevalley.oryuploads/Community Development/DocumentsrFormsBwilding/PlumbingPmmitApplication060309.doc Buil&og LT6oer �'+'- `• _. Name:p Phone: Fax: R/// / o1v,P// State: /A Zip �• Address: So // 7`lr City: /s. , i. I Y'I ,Contractor / is, Nae: C 0 tit 0 ha/n o.: Phone:%2 y 5 «F's Fa Marne: Address / 9, /ii city. G,A , G a State: .4Zip:a O License No: C City Business Lic Contact/Pr9jeet Manager /„ Name: a / 7 `�-7—rVl //(70 / r 6 (/IrcA a /i? lime: i / It OF UNITS FIXTURE ON A TRAP PLUMBING TOILETS URINALS TUBS SHOWERS (per trap) Lav/BasIns, Bar, Floor, Kikden, Laundry, Utility, Janitor, Photo, X-ray, Food, Prep/Culinary Meat SINKS DISHWASHER WASHER CLOTHES GARBAGE DISPOSAL WATER'SOFTNER FLOOR DRAIN Area, Case, Coil, Trench, Condensate DRAIN/OVERFLOW DRAINS , ROOF FOUNTAIN, DRINKING WATER PIPING/DRAIN-IN WASTE Installation, Alte2fi011s, Repair, Reversals WATERIUSING 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 Including turps, vents except kitchen type grease Interceptors functioning as future traps INCEPTORS REPAIR OR ALTERATION Water piping, drainage or vent piping ATMOSPH4RIC TYPE VACUUM BREAKER t BACK FLOW PROTECTIVE DEVICE Other than atmospheric type vacuum breakers MEDICAL GAS INCEPTORA DCASH ❑ CHECK 0 VISA 0 MC Garda SIGNATURE: EXPIRES: VIN: CURREIJT FEES AVAILABLE AT: http:/Avww.spokanevallev.orq/ under the quick links for Forms, Master Fee Schedule. htlpY/www.spokanevalley.oryuploads/Community Development/DocumentsrFormsBwilding/PlumbingPmmitApplication060309.doc