1985, 08-14 Permit App: 00007093 Plumbing FixturesPLUMBING PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
1 Owner's Name (Last) , (First) (M)
SC k .v e (OM/Le; &/. /CO 0
Department Use Only
Project No.
2 Project Address (Not Mailing Address) Space Zip
S. )9 1, C®A/KL1
3 City/Community
State
Subdivision/Plat Name
4 Assessor Parcel No.Lot
(&15 r) 1
Block
700/
16 Contractor Firm Name
SNAPPY PLUMBING. INC.
Street Address
N. 7520 Market St.
17 Zip
99207
City
Spcksne
State
Washington
Phone
( ) 467-842.3
18 Contact Person
I License No.
SNAPPI»222DZ
Phone if different than above
8 Owner/Agent (if different than #1 above)
Business Address
9 Zip
City
State
Phone
( )
15 Describe Work: New Addition/Alteration ❑ ; Replace/Repair ❑
Total Number %j
of Fixtures: /6
10 Applicant Name
Street Address
11 Zip
City
State
Phone
( )
9 Bar Sink(s):
Drinking Fountain(s):
Floor Drain (s): /
Washing Machine(s):
10 Dsh Wshr(s): /
Garb Disp(s): /
Kit Sink(s): /
LndryTray (s):
Sew Eject(s):
11 Urinal(s):
WtrCloset(s):3
Lav(s): "3
Shower(s): 4 /
1 Tub(s):
Bidet(s):
Other: Type;
12 Waste/Grease Interceptor(s):
13 Sewer Y N Septic/ Health No.:
14 Electric Water Heater(s): 1 — wt -1 ,
Drains -Roof:
15 REPAIR OR ALTERATION: Drainage, Vent, Water Piping/Treatment: Y N
16 Lawn Sprinkler System(s), including backflow device on any one meter:
17 Vacuum breakers or backflow devices In excess of line 16: 1-5:
(005 +:
I certify that the above information as submitted by me is true and correct and further, agree that all pro-
visions of laws and ordinances governing this type of work, including inspection requirements, will be com-
plied with whether specified herein or not. The granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state of local laws regulating construction or the performance of
construction.
SIGNATURE OF
OWNER OR AGENT
APPLICATIONcc
DATE'�