HomeMy WebLinkAbout1992, 09-23 Permit App: 92007976 SewerSEWER/PLUMBING PERMIT APPLICATION FORM
INFORMATION WORKSHEET
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JOB STREET ADDRESS: E. I So04 G.TtAri e �� �� I f _
CITY/STATE/ZIP: �okc.nal UR- PARCEL NUMBER: (,
MAILING ADDRESS: .34s.e
OWNER: Farrel- ICOR per PHONE NUMBER: S2$-SSsZ-
(Street) (City/state) (Zip)
CONTRACTOR: H £ 5 CANS712UCTIONI LICENSE NUMBER: HSCON ## I23Kg
PHONE NUMBER: slab -s%4
MAILING ADDRESS: II817 [ALLEYWAY AVE SPOkr NE WA c4a0(a
(Street) (City/state) (Zip)
DESCRIPTION
SEWER CONNECTION
PLUMBING ALTERATIONS
SIGNATURE
X EACH
UNIT
=AMOUNT
X 50.00 = y
X35.00=
SUBTOTAL
$
EQUALS: TOTAL
PEMIT FEE DUE
_$ So'
Spokane County Department of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509)456-3675