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2004, 03-02 Permit: BLD-04-03656 Sprinkler Systemr.�rk� or soal�ane .00.' 1 a11ey 11707 E. Sprague Ave., Suite 106 Spokane Valley, WA 99206 Job Address: 702 N GREENACRES RD GREENACRES WA 99016 Description: SPRINKLER SYSTEM Subdivision: Owner: Applicant: Address: ORR, EDWIN R 4 PLUMBING PERMIT Permit #: BLD -04-03656 Applied: Issued: Expires: Lot: Blk: Parcel No: Zoning: ORR, EDWIN R Phone: 608 N GREENACRES RD GREENACRES, WA 99016-9536 Contractor: Phone: Address: Lic No: 03/02/2004 03/02/2004 08/29/2004 General Information: SUPPLEMENTAL PERMIT CROSS CONNECTION DEVICE SPRINKLER SYSTEM N 1 0 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 rirights granted by any issued permit inure to the property ow q/f Print Name Staff Initials Signature Date THIS IS NOT A RECEIPT