2003, 04-07 Permit App: BD-03-038 ACHpr U7 Ui U'/:27a Hir Choice
MAR 29 2003 14:24 FR
City of
SPOKANE VALLEY
SU�bc r t"1 F'.
TO 6247741 P . B2/[T2
FLUMBING/MECHANICAL
PERMIT APPLICATION &
PERMIT # (a3 - (;�
Contractor Information
Job Address
E-20409
ConA+saor'
143
�b"?1
CPhone Number
qq
Floor, Count/ Schedule of Work
Me cktasitpel
Nan kber
Tend
T41 -
L2,
Bawer he
ransom (ap tie 100,000hht )
Gas Mot Water Hater
teeieTbp & other appliances
Cloths &spar
Ceaversien barna:
Gar see fireplace :slut
Wand autos system
Appliance vest repair- relocation
.
Laundry Waste / utak
- Ate loth ts tam
Unit Mater (oP 100.!
Mater00 btu )
Pierehoerc (~rood -patient)
Hvaptiw.eooaers
Conmaeia: Hoed
ifaltesat vets
Dude ant=
GanPip6sti ( sashes) .
(S 1. for every assist tinted)
•
rota!
Fee buts 35
Applicant Information
t7wieer6P f z{ fG(' l.(1��
•U�/f rcxc
City' �XrL o s
Owner phone amber
(5 -75. -acts?
Tex Parer! Namber (errors Nrcatberj
Cowbarror's Petr awl (sr copy) amusi bepresent7ed at
time el'srrbmmavL
SU.
315. a
stn es
510.ea
510. as
510.
SA to
=S.
57.5:Ias
510.ea
512.
5U. ea
210. a
532. as
512. ea
SLea
$u.
SS.=pta4outlets
F1umM rg Basic fee X35.
Number - Tenets Drinan $ 6. e■
Tib k faaects S s. ea
Sheerer heads S 6. as
Dakotas slake 5 6. es
Mochas siaio. 5 6. ee
Dishwashers 5 6. et
Sat water oak 510. a
Lawn epdnkling system 125.
/ravage sewage mass SRO.
V'satne type breaker (5) STS.
Dates toaatainc S 6. ea
Vast Drains S 6. ea
sump . S 6. as
Daddiow precentor $ 6. ea
predrat * e repair $ 6. en
Rose Sib S 0. es
Fee Cost 3
I herebyaatareoeethetallyetSpokaaeVatigtoe;argethefearerthispermit%mitcreditesrd:
dD
Total S
-
�-
Visa M cterarcd Ne. expiration date
HOMEOWNER INSTALLER ONLY
Ibeebytaffy thatIentheownerefthopropatytis ibedmthisapplioetiao.rustle:4HWthat
ate work sa dieu111Loopoolipsiiou gpproval by die CilereSpolo toraftsodO tlws{ywotdlswad,
otherporowsOrekdiYsl asaliaasdn.csor,tod:anyworkrreierattrianwit.
FOR OFFICE USE ONLY
Dab received
&Ppinonette'hiPamir Nn :
Permit Number
issued By:
s-vmapi
Dame
Circle ere: iIDablaS
•
Date l'ermdrIssued
APR 04 2003 07:28
Date
Mechanical
Fee collected $
(Both
This document originally contained
confidential credit card information which
was redacted pursuant to RCW 19.255.010
and the original document destroyed
pursuant to SOS DAN GS2014-030.
AMIS
** TOTAL PAGE.02
5096247741
PAGE.01