1985, 09-24 Permit App 00007780 Plumbing FixturesW
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PLUMBING PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
1 Owner's Name (Last) (First) (M)
FR.. C- t 6,-a,tt)On/
Department Use Only
Project No.
2 Project Address (Not Mailing Address) Space Zip
E. 1CD.I9 0Ki'CIw0o0 C-I- ,
3 City/Community
I State
Subdivision/Plat Name
4 Assessor Parcel No. (7Y` 1/ )
I Lot
Block
16 Contractor Firm NameL!/I
SNAPPY PLUMBING, INC.
Street Address
N. 7520 Market St.
17 Zip I City
99207 I Spokane
State
Washington
Phone
( ) 467-3423
18 Contact Person I License No.
SNAPPI-222DZ
Phone if different than above
1 8 Owner/Agent (if different than #1 above)
Business Address
9 Zip
City
I State
Phone
( )
15 Describe Work: New ❑ : Addition/Alteration CI; Replace/Repair CITotal
Number
of Fixtures:
10 Applicant Name
Street Address
11 Zip
City
State
Phone
( )
9 BarSlnk(s):
Drinking Fountain(s):
Floor Drain (s):
, Washing Machine(s): /
10 DshWshr(s): I
GarbDisp(s): /
KitSink(s): /
LndryTray(s):
SewEject(s):
11 Urinal(s):
I WtrCloset(s): 3
Lav(s): 9
Shower(s): /
Tub(s): Z
Bidet(s):
Other: Type;
12 Waste/Grease Interceptor(s):
13 Sewer NI) Septic/Health No.:
14 Electric Water Heater(s): C /- S
Drains -Roof:
15 REPAIR OR ALTERATION: Drainage, Vent, Water Piping/Treatment: Y N
16 Lawn Sprinkler System (s), including backflow device on any one meter:
I17 Vacuum breakers or backflow devices in excess of line 16: 1-5:
(Or) 5+:
I certify that the above information as submitted by me is true and correct and further, agree that all pro-
visions of laws and ordinances governing this type of work, including inspection requirements, will be com-
plied with whether specified herein or not. The granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state of local laws regulating construction or the performance of
construction.
066
SIGNATURE OF
OWNER OR AGENT
APPLICATION
DATE