2004, 08-25 Permit: BLD-04-07459 Plumbing FixturesC.7TY GIF 0•01\tofti,
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11707 E. Sprague Ave., Suite 106
Spokane Valley, WA 99206
PLUMBING PERMIT
Job Address: 19023 E SHANNON LN
GREENACRES WA 99016
Description: 1 -DOUBLE CHECK VALVE, 1 -HOSE BIB RELOCATION
Subdivision: Lot:
Owner:
Applicant:
Address:
Contractor:
Address:
MIKE TURBAK
MIKE TURBAK
19023 E SHANNON LN
GREENACRES, WA 99016
Blk: Parcel No:
Phone: (509) 954-7576
Phone:
Lic No:
Permit #: BLD -04-07459
Applied:
Issued:
Expires:
Zoning:
08/25/2004
08/25/2004
02/21/2005
General Information:
SUPPLEMENTAL PERMIT
WATER USING DEVICE
CROSS CONNECTION DEVICE
N
1
1
Fees:
PLUMBING PROCESSING FEE
WATER USING DEVICE
CROSS CONNECTION DEVICE
Total Calculated:
Deposits/Receipts:
Total Due:
35.00
6.00
6.00
47.00
47.00
0.00
Disclaimer:
The permitee verifies, acknowledges and agrees by their signature that: 1) If this permit is for construction of or on a dwelling, the dwelling is/will
be served by potable water. 2) Ownership of this City of Spokane Valley Permit inure to the property owner. 3) The signatory is the property
owner or has permission to represent the property owner in this transaction. 4) All construction is to be done in full compliance with the City of
Spokane Valley Development Code. Referenced codes are available for review at the City of Spokane Valley Permit Center. 5) This City of
Spokane Valley Permit is not a permit or approval for any violation of federal, state or local laws, codes or ordinances.
101 MEL -rof29
_I Owner.
Ownership of resulting development rights granted by any issued permit inure to te pr
Print Name Signature
Staff Initials
THIS IS NOT A RECEIPT
45-109
Date