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1992, 12-16 Permit: 92011008 Plumbing ReversalSPOKANE COUNTY DEPARTMENT OF BUILDING AND SAFETY W. 1303 BROADWAY AVENUE SPOKANE, WASHINGTON 99260 (509)456-3675 SIGNATURE OF OWNER OR GENT I , '-^' DATE ICATIONU kf //_ H'.� PROJECT NUMBER= 92011008 1,991JED PERMIT BATE= 12/i6/92 PAC: E::= M PERMIT INFORMATION SSl'EE .";IREEI== 10£103 E iOTH AVE: F'ARCEi..;:= 452i3.9i7P ADDRES'S== SPOKANE WA 99206 PERMIT USE= PLUMBING REVERSAL PLA'T4= 999999 PIAT NAME= RANGE DLOCI<== L.CT== -.,ONE= AG.RI Dl' ,14. AREA=- 00024000 F/A= F WIDTH= DEPTH= R/W= 40 OF DLDGE= 1 0 DWEL.L.INGS= i WATER DIST' _ OWNER:::: POTTER, I_ORFEN PHONE= .31RE:EI"= 10,803 E: i 0Tl-I AVE ADDRESS== SPOI(ANE WA 99:06 CONTACT NAME= TRIFLE S PHONE: NUMBER== 9509 9:26 R "9 6 BL; I LDING SETBACKS: FRONT== N/A L.. F..FI== N/A RIGHT.- NIA REAR== NIA PLUMBING PERMIT CONTRACTOR= TRIPLE S CONTRACTING PHONE= 509 927 8256 STREET= 11322 E BROADWAY AVE ADDRESS== SPOKANE WA 99206 ITEM IiE:S'CR.IPIION QUANTITY FEE. AMOUNT _........__.__._ P'ROCESS'ING .... .... _... _"...... _...____....... ... _._ FEE Y 25.00 MIECEI_.L.ANEOUS 1 6.00 MINIMC!M FEE ADJUSIMECNI" Y 4,00 PAYMENT SLIMMANY PAYMENT DATE:. RECEIPT" PAYMENT AMOUNT 1?/16/92 5317 35.00 TOTAL. DUE= .ii0 TOTAi_ PAID== :3`i. 00 PERMITIYPE:: FEE.' AMOUNT AMOUNT PAID AMOUNT OWING PLUMBING PERMIT 3.`.5.00 35.0(1 .00 3.5.00 31;.00 .00 PROCESSED BY: DOMITROVICH, ROBIN PRINT ED BY: DOMII'ROVTCH, ROBIN THANK YOU