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2013, 03-25 Permit App BLD-2013-0500 Plumbing FixturesPermit Center �L 13 - 0 SOe� 'le 11703 E Sprague Ave, Suite B-3 PERMIT NUMBER: s Spokane Valley, WA 99206 VaE1ey` (509)688-0036 FAX (509)658-0037 PERMIT FEE: Penn itcenter a).pokaneval ley.org Community Development Plumbing Permit Application ❑ Commercial 0 Residential SITE ADDRESS: Boildiug:Owner _ Name: Phone: Fax: Address: City: State: Zip: .Contractor _ Name: P (�1 Phone: 4.22- SC>Oo Fax: el. Address: 1/ o E City. State: - Zip: 4 72p6 License No: a �= Z—C t7 i City Business Lic: Contact/Pr icet mitua l': Name: a� t Phone:g .7 _ b Gx5it # OF UNITS PLUMBING FIXTURE ON A TRAP TOILETS if URINALS TUBS SHOWERS rtra SINKS LavBasins, Bar, Floor, Kitchen, Laundry, Utility, Janitor, Photo, X-ray, Food, PreplCulinary Meat 2— DISHWASHER CLOTHES WASHER GARBAGE DISPOSAL WATER SOFTNER FLOOR DRAIN Area Case Coil Trench Condensate ROOF DRAIWOVERFLOW DRAINS FOUNTAIN DRINKING WATER PIPING/DRAIN-IN WASTE Installation Alterations Repair, Reversals WATER USING DEVICE lee and/or Coffee maker, hose bib steamer punier, carbonalor, swamp cooler PRIVATE SEWAGE DISPOSAL SYSTEM WATER HEATER If Gas See Mechanical INDUSTRIAL WASTE PRETREATEMENT INCEPTORS Including traps, writs except kitchen type grease interceptors functioning as fudure 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 37 ❑CASH ❑ CHECK ❑ VISA ❑ MC EXPIRES: Card# VIN: SIGNATURE: - CURRENT FEES AVAILABLE AT: htto://www.sookanevallev.oro/ under the quick links for Forms, Master Fee Schedule. http://www.spokmevalley.orgluploWCo==tX_DevelopmmVDocumentsTomsBuilding/PlumbingPemitApplicationO4O3O9.doc 67 =G