Loading...
1992, 08-04 Permit App: 92005798 SewerSEWER/PLUMBING PERMIT APPLICATION FORM 0\ �Z_ 5 a I INFOAMATION WORKSHEET JOB STREET ADDRESS: CITY/STATE/ZIP: S 4-5 kve� OWNER:/f•'//c/ pr. MAILING ADDRESS: G CONTRACTORA S. C MAILING ADDRESS: (Street) PARCEL NUMBER: ed PHONE NUMBER: Pol 0) (i/ (City/state) LICENSE NUMBER: PHONE NUMBER: L aEr- (Street) (City/state) (Zip) DESCRIPTION SEWER CONNECTION PLUMBING ALTERATIONS SIGNAT X EACH UNIT =AMOUNT X50.00= St X 35.00 = ? 5 SUBTOTAL $ EQUALS: TOTAL P,EMIT FEE,.DUE =$ j �5' 4 / ✓_.i Spokane County Department of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509)456-3675 y.52a033