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2009, 06-03 Permit App 09001595 Floor Drainff1 SpCokane. Permit Center 11703 E Sprague Ave, Suite B-3 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 permitcenter@spokanevallcv. org PERMIT NUMBER: L/1-- /-( S^ PERMIT FEE: Community Development Plumbing Permit Application n Commercial Residential SITE ADDRESS: I () I �/ € C l D( (d iQ S po I cli .. II i tI1% IT q q Z I Z Building Owner Name: Dom In i (i t'r� Phone: Zl G ©(6 2 Fax: Address: tine `i € rat aterld6 City: S eregL1G, �/t% State: 6/A Zip: (707�/ z / Contractor? Name: U,�Db1aJ i�Vi�l Phone: ti �9 17,4 �6 Fax: Y- CJV i `l 1 ' ��7 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) SINKS Lav/Basins, Bar, Floor, Kitchen, Laundry, Utility, Janitor, Photo, X-ray, Food, 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 V INCEPTORS ❑CASH ❑ 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://www.spokanevalley.org/uploads/Community Development/Documents/FormsB uilding/PlumbingPermitApplication040309.doe