2008, 06-27 Permit App 08002455 Plumbing FixturesPERMIT NUMBER
PERMIT FEE:
Building Owner
Permit Center
11703E Sprague Ave, Suite B-3
Name:Phone:
Spokane Vallry, WA 99206
_
(509)688-0036 FAX (509)688-0037
Community Development
www.s a re rkanevalle .oe
Plumbing Permit Application [
State: Zip:
SITE ADDRESS -
PERMIT NUMBER
PERMIT FEE:
Building Owner
Name:Phone:
_
10 y Fax:
Address:
City.
State: Zip:
Contractor
Name. c
ch Phone:
Fax: 'L
Address: O
Cit3,.
State: Zip: c C_
License No: _
City Busm
s Lic:
Contact
Name:
v c
Phone:
P el
L
DESCRIPTION OF WORK # OF UNI75 X COST - TOTAL AMOUNT
1 TOILETS WATER CLOSET, BIDETS X 56.06 - L-
2 URINAI S X S6. n6 I =
5 1 SINKS
LAVSBASINS, BAR, FLOOR, K
LAUNDRY, UTILITY, JANITOR,
X I $6.00 I =
16 WATER USING DEVICE STEAMER^ X $6.00 _
PROOFER, CARBOW TOR, SWAMP L 2
COOLER
VACUUM BREAKER, CHECK BREAKER, CHECK VALVE
AND RP.B.P.D. FOR VATS, TANKS,
METHOD OF PAYMENT_:
OCASH 0 CHECK MVISA ❑
Card#
AUTHORIZED SIGNATURE:
EXPIRES:
I TOTAL PERMIT FEE DUE: I f / 7 1
Effective October 28, 2007
PACommunity DevelopmentTormstBuilding f6rinaTlumbing Permit Application.doc