2004, 04-12 Permit: BLD-04-04046 Plumbing Fixtures CITY or I"M
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PLUMBING PERMIT • •
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11707 E. Sprague Ave.,Suite 106
Spokane Valley,WA 99206 Permit#: BLD-04-0046
Job Address: 11621 E 16TH AVE Applied: 04/12/2004
SPOKANE ,WA 99206-5413 Issued: 06/02/2004
Description: TOILET,SINK AND SHOWER Expires: 11/29/2004
Subdivision: Lot: BIk: Parcel No: 45214.1413 Zoning:
Owner: MANNICK,JACOB&VICTORIA R •
Applicant: MANNICK,JACOB&VICTORIA R Phone: (509)939-2817
Address: 11621 E 16TH AVE
SPOKANE,WA 99206-5413
Contractor: Phone:
Address: Lic No:
General Information: Fees:
SUPPLEMENTAL PERMIT Y PLUMBING PROCESSING FEE 7.50
TOILETS 1 TOILETS 6.00
SHOWERS(PER TRAP) 1 SHOWERS _ 6.00
SINKS 1 SINKS 6.00
Total Calculated: 25.50
Deposits/Receipts: 25.50
Total Due: 0.00
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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 inances.
Ownership of resulting develop nt rights granted by-• issued per it i if e to the pr•perty .t'ner.
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Print Name Sig ,- ure / Date
Staff Initials
THIS IS NOT A RECEIPT