2007, 12-03 Permit App: 07004743 Plumbing FixturesPamft Center
Oi{ai1C 11703 ES vague Ave, suite eaPERMIT NUMBER:
�tUh"JL�, Spokane Valley, WA 99206
�'(509)688-0036 FAX (509)658-0031 PERMIT FEE:
Commumry Development v'.),,anerallz or
Plumbin8 Permit Application ❑ Commercial XRsidential
SITE ADDRESS: 7Z12,� F/ Ty
Building OwnergTkJ/LIlfl Al
[ ✓��
Name:
Phone:
ys- .Z�./ F. <
Address:
2/ �(- �-. TN
City
S PO K /VE state:
--
Coacr.ctor
�LLu2E NSTi�(�7lON
CS/(,/✓
Name:
Fax. 9
-7 (f,,)LfO
Address.
p A/ 6[ NTiiv nni
City
5 PO ME Stan: zo"i _
zip` 9 Z r
LicenseNo:
LZ- 14 LC -01 -�
City Business
Li¢ue7�
Contac[
� �G
Name:
Phone:
q
o�y / l
AUTHORIZED SIGNATURE:
aevrseo etz0os