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2003, 07-21 Permit: BLD-03-02058 Plumbing FixturesSO:Wane a Valley 11707 E. Sprague Ave., Suite 106 Spokane Valley, WA 99206 4S - PLUMBING - RESIDENTIAL Job Address: 5009 N LARCH RD SPOKANE WA 99216-3527 Description: 1 TOILET, 1 TUB, 1 SINK, 1 CLOTHES WASHER, 1 FLOOR DRAIN Subdivision: Owner. Applicant: Address: Contractor: Address: BARTHOLOMEW, MICHAEL A GOLD SEAL SERVICE 5524 E BOONE AVE SPOKANE, WA 99212-0903 GOLD SEAL SERVICE 5524 E BOONE AVE SPOKANE WA 99212-0903 Lot No: Phone: (509) 535-5946 Phone: Lic No: (509) 535-5946 GOLDSS'1330S Permit #: Applied: Issued: Expires: BLD -03-02058 07/21/2003 07/21/2003 01/17/2004 General Information: SUPPLEMENTAL PERMIT TOILETS TUBS SINKS CLOTHES WASHER FLOOR DRAINS N 1 1 1 1 1 Fees: PLUMBING PROCESSING FEE TOILETS TUBS SINKS CLOTHES WASHER FLOOR DRAINS Total Calculated: Deposits/Receipts: Total Due: 35.00 6.00 6.00 6.00 6.00 6.00 65.00 65.00 0.00 Disclaimer: Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and finds the information contained within to be true and correct, and agrees that all provisions of laws and/or regulations goveming this type of work will be in compliance. Subsequent issuance of a permit shall not be construed to be a permit for, or an approval of, any violation of any of the provisions of the code or of any other state or local laws or ordinances. Ownership of resulting development rights granted by any issued p Applicant Please print name here t i . r- o e property owner. Date Counter Approval