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1985, 11-25 Permit App: 00008883 Water Softener • PLUMBING MEMAWCAL PERMIT APPLICATION WORKSHEET PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND Project# '�� _7 Owner's Name Last First MI SCHWARTZ c Charles Project Address(Street Name&Number) City State Subdivision/Plat Name Assessors Parcel# Lot Block Plat# Applicant Address SCHWARTZ, Charles II. S. 4407 Skipworth City State Zip Phone pokane WA 9920E 926-5594 Business Phone Contractor Address y Soft Water Service Co. E. 25 Third City Spokane State WA Zip 99202 Phone 455-8050 Contact License# Business Phone Describe Work Installed 'Water Softener Fans Evaporative Cooler Hoods Electric Furnace/Ducts Miscellaneous Dryer Range Gas Log Gas Water Htr. Solid Fuel/Wood Stove 0-10,000 CFM 10,000+CFM Air Handling Units Refrigeration Systems/ 1-100M 101-500M 501-1,000M Heat Pumps(BTU) 1,001-1750M Over 1750M Compressor 0-3HP 3-15HP 15-30HP 30-50HP 50+HP 1-5 Outlets 6+Outlets Gas Piping Gas Fired Heating System 1-100,000BTU 10,,;.00+BTU 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 state of local laws regulating construction or the performance of construction. SIGNATURE OF Soft 1'4ater ServiceCo. APPLICATION OWNER OR .DATE sNN