1993, 09-30 Permit App: 93009041 Sewer`-15213 , tovag
�I Aid SEWER/PLUMBING PERMIT APPLICATION FORM
`s5 INFORMATION WORKSHEET
JOB STREET ADDRESS S 922 Pierce
CITY/STATE/ZIP: Spokane, WA 992016ARCELNUMBER:
OWNER: Rickie B Miller
9,3 -
c!3$ -?c
PHONE NUMBER: 658-0394
MAILING ADDRESS: 12428 45th DR. NE , Maryville, WA 98270
(Street) (City/state) (Zip)
CONTRACTOR: ALLOM5 ACTIVE LICENSE NUMBER: ,A LW AV A*.iOto95
,MAILING ADDRESS:
PHONEINUMBER: C3a?- 8500
ice-. O. �,X. S•POkANE WA 99a 1 q
(Street) (City/state) (Zip)
DESCRIPTION
SEWER CONNECTION
PLUMBING ALTERATIONS
SIGNATUR
X EACH
UNIT
=AMOUNT
X50.00=
50.00
X 35.00 =
SUBTOTAL
$
EQUALS: TOTAL
PEMIT FEE DUE
=$
50.00
Spokane County Department of Buildings
est 1303 Broadway Avenue Spokane, WA 99260 (509)456-3675
AUG -10-'93 TUE 10:09 ID:LABOR & IND. SP-OKANE TEL NO:509 324 2636
AUG -10-'93 TUE 09:31 ID: TUMW TER LOCATION. TEL HP: 20g 239 3461
apututuiof Labor & loasories
Ceattiesorarratloa9aoaoe
Po ilee
Olympia WA o1%4 4430
t#685 P02
U176 P01
REGISTRATION VERIFICATION
rags
....__I.beavt2_101-1x4k)474,-
(200 951.4122f
SCAN 204216
FAX c I436ti12$
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' Contractor: Your Certificate of Registration will be sent from the Olympia office and
should o received tin 2 to 3 weeks. Plage keep this record until you receive your
Thank you
cl Oki
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