2004, 05-28 Permit: BLD-04-04462 Lawn Sprinkler CITY G1F �►
Spoke
,r0,000Milley PLUMBING PERMIT
11707 E. Sprague Ave.,Suite 106
Spokane Valley,WA 99206 Permit#: BLD-04-04462
Job Address: 12126 E 6TH AVE Applied: 05/28/2004
SPOKANE WA 99206-5386 Issued: 05/28/2004
Description: INSTALL LAWN SPRINKLER SYSTEM Expires: 11/24/2004
Subdivision: Lot: Blk: Parcel No: 45211.2307 Zoning:
Owner: TILTON,TRAVIS L
Applicant: TILTON,TRAVIS L Phone: (509)995-5644
Address: 12126E 6TH AVE
SPOKANE,WA 99206-5386
Contractor: Phone:
Address: Lic No:
General Information: Fees:
SUPPLEMENTAL PERMIT N PLUMBING PROCESSING FEE 35.00
CROSS CONNECTION DEVICE 1 CROSS CONNECTION DEVICE 6.00
Total Calculated: 41.00
Deposits/Receipts: 41.00
Total Due: 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.
Ownership of resulting development rights granted by any issued permit inure to the property owner.
jACt-1/4/17 0•
Print Name Signature Date
Staff Initials
THIS IS NOT A RECEIPT