1986, 12-10 Permit: 00014476 Water Softener , 4
SIGNATURE OF APPLICATION
OWNER ORAGENT DATE
JOB ADDRESS PROJECT#
IA, . = DATE:
15111 L 12TH AV ^' uol6097 12/10/86
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BIRCHARD/ JOHN A PLUMBING
ADDRESS:
51l1 E 12TH AV Amount Difference
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V[ WA 99037
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235� ' 0 099900
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UATER SOFTENER
USE OF ,"=°.,. FEES: ,.., ,,. CA C° = NC .
$20 . 00
JOB ADDRESS: COUNTER APPLANS EXAM: DATE:
12TH AV /
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PLUMBING PERMIT
PLUMBING TOTAL FEE $19 . 00
FIXTURES : Bar Sink 0 Drinking Fount 0 Floor Drain O Fee 4 . 00
C/W Pipe 0 Dish Washer 0 Kitchen Sink 0
Laundry Tray Sewer Eject 0 Water Closet
Lavatory 0 Urinal 0 Shower
Tub 0 Bidet O Other 01
Garbage Disposal 0
Sewer ? N Septic/Health # 0
Processing Fee 15 . 00
12r10 - 6 67505 * 20O06
OFFICE COPY
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