1985, 11-25 Permit App: 00008900 Water Softenerrn
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PLUMBING PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
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 APPLICATION
Soft Water Servcie Co.
OWNER OR AGENT DATE
Project M 0C/00
Owner's Name Last First MI
HAIGHT HARRY GLf'.1
Project Address (Street Name & Number)
City
State
Subdivision/Plat Name
Assessors Parcel M
6ZS'}1.-(..)03
Lot
Block
Plat N
Applicant
Same
Address
N. 4713 Burns
CityState
Spokane
I WA
Zip
99216
Phone
924-4434
Business Phone
Contractor
Soft Water Service
Address
:o. E. 25 third
City
Spokane
I State
WA
Zip
99202
Phone
455-8050
Contact
License M
Buslneea Phone
Describe Work
Bar Slnk(s):
Drinking Fountain (s):
Floor Drain (s):
Washing Machine(s):
Deh Wshr(s):
Garb Disp(e):
Kit SInk(s):
Lndry Tray(s):
Sew Eject(s):
Urinal(s):
WtrCloset(s):
Lav(s):
Shower(s):
Tub(s):
Bidet(s):
Other: Type; Water Softener
Waste/Grease Interceptor(s):
Sewer Y N Septic/Health No.:
Electric Water Heater(s):
Drains -Roof:
REPAIR OR ALTERATION: Drainage, Vent, Water Piping/Treatment: Y N
Lawn Sprinkler System (s), including backflow device on any one meter:
Vacuum breakers or backflow devices in excess of line 1-5:18.. A,
(Or) 5+:
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 APPLICATION
Soft Water Servcie Co.
OWNER OR AGENT DATE