1986, 07-23 Permit App: 00012260 Water Softener0
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PLUMBING PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
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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