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1986, 05-21 Permit: 00011133 Plumbing FixturesPr' � � 3|GNATVREOF ^/� APPLICATION OWNER ORAGENT DATE JOB ADDRESS PROJECT 3220 S PINES' RD 0°—" HIMALAYA, HOMES INC ^"=� `",. 3220 S PINES RD �� "`,. = ",. SPOKANE NA 99206 ^,,""^",. GOLD` SEAL MECHANICAL co--,.. GOLD SEAL MECHANICAL INC """"^"" 5524 E BOONE . AV ,,. ,.,. SPOKANE WA 99212 509-535~5944 COLDSM*298C4 ^"==". ",,. „ `.,. . ,^^,"`^ 335419884' ,^,~— 01168D80 003 001 . ,`^,°^~" � MIDILOME 4TH ADD • =""^' SFR ~"" 000 "' 000 "` 000 °"" 000 "°^ F 10 PLUMBINC FIXTURES "^^""""^"". '""""="= 3220 S PINES RD PLUMBINC PERMIT 8812323 05/21/86 00011133 PLUMBING $55.88 ~^= $55.08 A "" "° "" "^^°""`^°' DATE PLUMBINC - • TOTAL FEE $55.00 FIXTURES; Bar Sink 0 Drinking Fount 0 Floor Drain 01 Fee - 36.00 C/W Pipe 01 Dish Washer 0 Kitchen Sink 01 . Laundry Tray Sewer Eject 0 Water Closet 0 Lavatory 02 Urinal 0 Shower 01 ava ory Ton 01 Bide` 0 Other 0 • Garbage Disposal 0 Electric Water Heater 01 Roof Drains 0 Fee 4.00 Sewer ? N Septic/Health # 8 � Processing Fee 15^08 . ' �•7�`,6 "^ "OFFICE COPY ���0u ���0Uu `'°"� '^"°u INSP-ID /2i.1) Pi) 6%9 l&) "'23 - DATE 57n - - a 7c (4 114=-2_(# 4 Lid fii • co W 2 t1 0 W m i Z PLUMBING PERMIT APPLICATION WORKSHEET PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND IProject / / / 33 A Owner's Name Last, // First MI ri'lk4LostYi,' /c.K'vg Project Address (Street Name & Number) 2 2 - City State Subdivision/Plat Name Assessors Parcel N Lot Block Plat N Applicant Address City I State Zip Phone Business Phone Contractor • Gold Seal Mechanical Tnr Address 5524 E B nC City Spokane 1 State Wa Zip 99917 Phone 509 S35 5944 Contact R Dixon License N GO LD SM *290 C4 Business Phone Describe Work SFR Bar SInk(s): Drinking Fountain(s): Floor Drain (s): Washing Machine(s): ( Dsh Wehrle): Garb Dlep(s): Kit Sink(s):/ Lndry Tray(s): Sew Eject(s). Urinal (a): Wt Closet(s): O L/ Lav(s): 2-- Shower(s): / [ Tub(s): Bidet(s): Other: Type; Waste/Grease Interceptor(s): Sewer V N Septic/Health No.: Electric Water Heater(s): l l 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+• 4©ffi a 5- S 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 otFjer-state of local laws regulating construction or the performance of construction. SIGNATURE OF OWNER OR AGENT APPLICATION — DATE ��