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Home My WebLink About1992, 10-14 Permit App: 92008638 SewerSEWER/PLUMBING PEP MIT APPLICATION FORM (� INFORMATION WORKSHEET CIaS " 1 q JOB STREET ADDRESS: S /0 // /6,6_ q Q,.. Ic-3D CITY/STATE/ZIP: 6/(22-/ PARCEL NUMBER: MAILING ADDRESS:,, OWNER: /)/ r M / PHONE NUMBER: (Street) (City/state) (Zip) CONTRACTOR: A LWP`1 S ACTIV E LICENSE NUMBER: A LLAy Avf,-c(oes PHONE NUMBER: 9as-85OO MAILING ADDRESS: 0. 0. -8©.( ly 1567 PpkANE WA 9qajy (Street) (City/state) (Zip) 44 DESCRIPTION SEWER CONNECTION PLUMBING ALTERATIONS SIGNATURE X EACH UNIT =AMOUNT X 50.00 = X 35.00 SUBTOTAL_ $ EQUALS: TOTAL PEMIT FEE DUE =$ , 0 Lyce_.--&-;- \,,,A),o.k."-,' \pck,'"e" cb-` 1.. Spokane County Department of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509)456-3675