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1986, 07-23 Permit App: 00012260 Water Softener0 W 1- X X LL 0 O w m z Z • R PLUMBING PERMIT APPLICATION WORKSHEET PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND gA3 1 Project # /Z2b 0 Owner's Name Last Flret MI Hoover Richard J Probed Address (Street Name 8 Number) City State Subdivision/Plat Name Pfttir(nu /ice/ Assessors Parcel N C --S f / / Lot Block Plat N Applicant Same Address E. 11901 Main City I State Spokane WA Zip 99206 Phone 924-4771 Business Phone Contractor Soft Water Service Co. Address E. 25 Third City Spokane 1 State WA Zip 99202 Phone 455-8050 Contact License N Business Phone Describe Work Bar Sink(s): Drinking Fountain(s): Floor Drain (s): Wash! gMachlne(s): Doh Wahr(s): Garb Dlsp(s): Kit SInk(s): Lndry Tray(s): Sew Eject(s): Urinal (a): Wt Closet(s): Levis): Shower(s): Tub(s): Bidet's): - Other: Type; Water Softener Waste/Grease Interceptor(s): Sewer V N Septic/Health No.: Electric Water Heater(s): Drains -Roof: REPAIR OR ALTERATION: Drainage, Vent, Water Piping/Treatment: V N Lawn Sprinkler System (s), including backflow device on any one meter: Vacuum breakers or backflow devices in excess of line 16:1-5: (Or) 5+: 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 Soft Water Service Co. OWNER OR AGENT DATE APPLICATION