1986, 12-10 Permit App: 00014466 Water SoftenerPLUMBING PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
I certify that the above information as submitted by me is true and correct and further, agree that all pro-
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
construction.
SIGNATURE OF
APPLICATION
OWNER OR AGENT Soft Water Service Co. DATE
Project of /`/`:
Owner's Name Last First MI
RAINER, WAYNE
Project Address (Street Name & Number)
City
State
Subdivision/ Plat Name
Assessors Parcel if
(Q061).
Lot
Block
Plat
Applicant
Same
Address S. 3401 Loretta Dr.
CityState
Spokane
I WA
Zip
99206
Phone
927-8707
Business Phone
Contractor
Soft Water Service Co.
Address
E. 25 Third
CityState
Spokane
I WA
Zip
99202
Phone
455-8050
Contact
License ft
Business Phone
Describe Work
Bar Sink(s): is
Drinking Fountain(s):
Floor Drain (s):
Washing Machine(s):
Deh Wshr(s):
Garb Disp(s):
Kit Sink(s):
Lndry
Tray(s):
Sew Eject(s):
Urinal(s):
WtrCloset(s):
Lav(s):
Shower(s):
Tub(s):
Bidet(s):
ci)W
CC
Other: Type; Water Softener
D
XWaste/Grease
Interceptor(s):
iI
O
2
Sewer Y N Septic/Health No.:
u
m
2
Electric Water Heater(s):
Drains -Roof:
D
Z
REPAIR OR ALTERATION: Drainage, Vent, Water Piping /Treatment: Y N
Lawn Sprinkler System (s), Including backflow device on any one meter:
Vacuum breakers or backflow devices In excess of line 16:1-5:
(005 + :
I certify that the above information as submitted by me is true and correct and further, agree that all pro-
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
construction.
SIGNATURE OF
APPLICATION
OWNER OR AGENT Soft Water Service Co. DATE