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2012, 08-06 Permit App: BLD-2012-1259 Plumbing`"""lane 4;00*%lley- Community Developmen: Permit Center 11703 E Sprague Ave, Suite B-3 Spokane Valley, WA 99206 (509)688-0036 *FAX: (509)688-0037 perm itceiner:ir-wo •a tevall v.or b'D-ZOIZ-12- 9 PERMIT NUMBER: PERMIT FEE: Building Owner Name: Phone: !f�' 7 Fay: Address: 3`f r'� Cera e_r City: State: Zip; Contractor Name:ezYr' (� h i�� ,1'C�.i/w'f�iGt�'a Phone: Cy(j Fax: Address: City: Zip: Cq W CA License No: City Business Lic: Contact/Project Manager: Name: Y' i^P�r Phone: �� s' OCASH O CHECK O VISA O MC EXPIRES: Card# VIN SIGNATURE r:\Community Development\02 Administration\03 Forms - Official VersionsWermit Center\Plumbing Permit Application 04-03-09 dg.doe