Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
1993, 03-09 Permit App: 93001344 Sewer
SEWER/PLUMBING PERMIT APPLICATION FORM -)`pC)INFORMATION WORKSHEET "7/Ck3- l3 CITY/STATE/ZIP: �' L? PARCEL NUMBER: OWNER: U'�- r�-�-4 PHONE NUMBER: MAILING ADDRESS: (Street) (City/state) (Zip) CONTRACTOR: COURCHAINE EXXAYk lot LICENSE NUMBER: COUECC44i8 4..e7 PHONE NUMBER: g6)4-51-185 MAILING ADDRESS: 6. 10402. VALLeiWm 4VE V'C-IZP LE kw 99037 (Street) (City/state) (Zip) DESCRIPTION SEWER CONNECTION PLUMBING ALTERATIONS SIGNATURE / t6 A6 Spokane County Department of Buildings West 446ft Broadway Avenue Spokane, WA 99260 (509)456-3675 X EACH UNIT =AMOUNT X 50.00 = X 35.00 = ,- ‘-z-c-- -z"SUBTOTAL SUBTOTAL $Jam' �- 6_`"., EQUALS: TOTAL4-Q PEMIT FEE DUE =$ 0