1987, 01-29 Permit App: 87000210 Water Softeners"a r a
PLUMBING PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
IProJectN 2 /0
V
Owner's Name Last First MI
Seay Judy
Protect Address (Street Name 8 Number)
City
State
Subd n/Plat Name
Td2(I� RD, AVS
Assessors Parcel #
/2531 - tion -7
Lot
Block
,-2-7°
Plat*
As
Applicant
Same
Add ess
7308 E. Utah
City 1
Spokane
State
WA
Zip
99212
Phone
922-7278 0
Business Phone
Contractor
Soft Water Service Co.
Address
E. 25 Third
City
Spokane
1 State
WA
Zip
99202
Phone
455-8050
Contac)
License
Business Phone
SO rM' MIAg jj hK
I lam/ V
Describe Work
Bar SInk(s):
Drinking Fountaln(s):
Floor Draln(s):
Washing Machine(s):
Dsh Wshr(s):
Garb DIsp(s):
Kit Sink(s):
Lndry Tray(s):
Sew Eject(s):
Urinal(s):
Wtr Closet(s):
Lev(s):
Shower(s):
Tub(s):
Bidet(s):
Other: Type; Water Softener
Waste/Grease Interceptor(s):
Sewer Y N Septic/Health No.:
Electric Water Heater(s):
Drains -Roof:
REPAIR OR ALTERATION: Drainage, Vent, Water Piping/Treatment: Y N
Lawn Sprinkler System(s), Including backflow device on any one meter:
Vacuum breakers or backflow devices In excess of line 16:1-5:
(005+ :
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 CoAPPLICATION
.
OWNER OR AGENT DATE