1985, 09-24 Permit App: 00007779 Plumbing FixturesPLUMBING PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
1 Owner's Name q-� (Last) (First) (M)
Department Use Only. '--']%
/ /n�1
F /P4 C fT al P-Ooe
Project No. / / 79-
2 Project Address (Not Mailing Address) / rI Space Zip
E /oad.l 0 R1/4t+w000 C4-,
3 City/Community I State
Subdivision/Plat Name
4 Assessor Parcel No.
rte^ /( (/,/-) /Q-)
Lot
Block
16 Contractor Firm Name
SNAPPY PLUMBING. INC.
Street Address
N. 7520 Market St.
17 Zip
99207
City
Spokane
State
Washington
Phone
( ) 467-8428
18 Contact Person
I License No
111 SiNAPF2-222PZ
Phone if different than above
8 Owner/Agent (If different than 41 above)
Business Address
9 Zip
City
I State
Phone
( )
15 Describe Work: New Addition/Alteration 0 Replace/ RepaRepairTotal
❑
,r
Numbers /
of Fixture/
10 Applicant Name
Street Address
11 Zip
City
State
Phone
( I
9 Bar SInk(s):
Drinking Fountain(s):
Floor Drain(s)•
Washing Machine(s).
10 Doh Wshr(s)' p'
Garb Disp(s): /
Kit Sink Oh /
Lndry Tray(s) /
Sew Eject(s):
11 Urinal(s):
Wt Closet(s): 6;v3
Lav(sp C
I Shower(s) 2
Tub(s): 2—
Bidets)
Other: Type;
12 Waste/Grease Interceptor(s):
`f
re
13 Sewer Ct.)
/N 1 Septic/Health No.
14 Electric Water Heater(s): CA 5 0'
Drains -Roof
15 REPAIR OR ALTERATION: Drainage, Vent, Water Piping/Treatment: V 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:
(Or) 5+'
I certify that the above information as submitted by me is true and correct and further, agree that all pro -
/0
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 r/ 73
construction.
SIGNATURE OF
OWNER OR AGENT
APPLICATION
DATE 9 -.029- JJ