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2012, 08-06 Permit App: BLD-2012-1260 Plumbing
��=2.612 - IZCQO Permit Center ""'"�p 11703 E Sprague Avc, Suite B-3 PERMIT NUMBER: ' 0) Spokane Valley. WA 99306 ` Valley (509)688-0036 FAX: (509)688-0037 PERMIT FEE Perm itegiter_Sranok•meval�v ore Community Development Plumbing PermitApplication❑ Commercial Residential SITE ADDRESS: J Building Owner Name: O G w !'hone: �QO Fas: Address: 3 5 h -fe-?' A7 CitY:C State: Contractor %alne' GL Y'Y`' {�r� r'le Y' ,�t: VLiK Address: / L` License No: Phone: �Z [:•��"Iar.�e� City: j >e, % G City Business Lie: Fay: State: i/�/ Zip: Contact/Project/Manager: Name: r `" M;' /O—r Phone: ^ ❑CASH ❑ CHECK ❑ VISA Q MC EXPIRES: Cara# VIN SIGNATURE t'ACommunity Development\02 AdministrationNO3 Forms - Official Versions\Permit Center\Plumbing Permit Application 04-03-09 dg.doc