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2004, 05-17 Permit: BLD-04-04384 Plumbing FixturesSpokane ..,,,•s'Milley 11707 E. Sprague Ave., Suite 106 Spokane Valley, WA 99206 Job Address: 2215 N GIRARD RD SPOKANE WA 99212 Description: CROSS CONNECTION DEVICE Subdivision: Owner: Applicant: Address: Contractor: Address: THIEMAN, RAYMOND E & GRACE L PLUMBING PERMIT Permit #: Applied: Issued: Expires: Lot: Blk: Parcel No: 35124.2806 RAMSEY PLUMBING & HEATING INC Phone: (509) 482-2775 4023 E CENTRAL AVE SPOKANE, WA 99217 RAMSEY PLUMBING & HEATING INC 4023 E CENTRAL AVE SPOKANE WA 99217 Phone: Lic No: (509) 482-2775 RAMSEPH125LC BLD -04-04384 Zoning: 05/17/2004 05/18/2004 11/14/2004 General Information: SUPPLEMENTAL PERMIT CROSS CONNECTION DEVICE N 1 Fees: PLUMBING PROCESSING FEE CROSS CONNECTION DEVICE Total Calculated: Deposits/Receipts: Total Due: 35.00 6.00 41.00 41.00 0.00 Disclaimer: The permitee verifies, acknowledges and agrees by their signature that: 1) If this permit is for construction of or on a dwelling, the dwelling is/will be served by potable water. 2) Ownership of this City of Spokane Valley Permit inure to the property owner. 3) The signatory is the property owner or has permission to represent the property owner in this transaction. 4) All construction is to be done in full compliance with the City of Spokane Valley Development Code. Referenced codes are available for review at the City of Spokane Valley Permit Center. 5) This City of Spokane Valley Permit is not a permit or approval for any violation of federal, state or local laws, codes or ordinances. Ownership of resulting development rights granted by any issued permit inure to the property owner. Print Name Signature Staff Initials THIS IS NOT A RECEIPT Date