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2013, 03-28 Permit App BLD-2013-0524 BackflowCar 28 13 04:11a te&cane.. y Permit Center 11703 E Sprague Ave, Suite 3-3 Spokane Valley, WA 99206 (509)6S8-0056 FAX (509)68S-0037 oMmi:c_ ter Astok'dneveliev.nr'2 Community Development Plumbing Permit Application SITE ADDRESS: _ _ 6l0(—(3-4z41 IPERMIT NUMBER: PERMIT FEE: 3 %y CO PVI ❑ Commercial 1SResidential Building Owner . _ Name: b act n , .GeY c2 n Phone: fa Z _v o `i Fax: 4 Zip: ',. Address City State: ,'7�pnr{ � ire, SSi on �J2 Contractor co r-e tler &r-2-en Sp,- ; n 1,/'{-S Name: Phone: 41 See--! 23 L! Fax: t Cj S%18 Address: p o . B O .< iu e! ci ! Cry. .Sp et. at tit State: �� A- MI: % q Z. % - . Linens: No: KorevG—Soi(o/BB City Business Lie: S p p ,E: a n . ContactiProject Manager Name: I.- 1 S Gt.. S A n de r Phone: g-0 q 4g q -! 2 3 Y $ OF UNITS PLUMBING FIXTURE ONA TRAP TOASTS URINALS' TUBS trap) SHOWERS (per SINKS Lev/Basins, Bar. Floor, Ktchen. Laundry, utility, Janitor. Photo, X-ray, Food, Prep/Culinary Meat DISHWASHER CLOTHES WASHER GARBAGE DISPOSAL WATER SOFTNER FLOOR DRAIN Area. Case. Cad, Trench. Condensate ROOF DRAIN/OVERFLOW DRABS FOUNTAIN. DRINKING WATER PIPING/DRAIN-IN WASTE Im1aIlGuon. Alterations. Repair. Reversals WATER USING DEVICE fee and/or Coffee mazer, hose bib. sMamer proo:er, carbonator. swamp voter PRIVATE SEWAGE DISPOSAL SYSTEM WATER fiEATER U Gas, See Mechaniml INDUSTRIAL WASTE PRETREATEMENT INCEPTORS Including traps. vents except kitchen type gren interceptors functioning as More traps REPAIR OR ALTERATION Water piping. dra eoe or vent piping ATMOSPHERIC TYPE VACUUM BREAKER BACK FLOW PROTECTIVE DEVICE Other Man atmospheric type vacuum breakers MEDICAL GAS INCEPTORS OCASH ❑.CHECK InVISA XMC EXPIRES: CaTCIO I. REDACTED - SIGNATURE: t� 0` Scoot g- REDACTED This document originally contained confidential credit card information which was redacted pursuant to RCW 19.255.010 and the original document destroyed pursuant to SOS DAN GS2014-030. CURRENT FEES AVAILABLE AT: htIo:fh xntspckanevaf'et.cm! under the quint( units for roans, waster ree acnepwe. htrp97wrvvispokmevalley.org/uploads/Community DevelopmenUDouuments/Forms/BuildirdPltmbingPefmirApplication04U309.doe