1993, 09-14 Permit App: 93008351 SewerSEWER/PLUMBING PERMIT APPLICATION FORM q3.- S 3
INFORMATION WORKSHEET _ !
904 S. Pierce Rd.
JOB STREET ADDRESS: 35T
CITY/STATE/ZIP: Spokane, WA 99206 PARCEL NUMBER:
OWNER: Norman Harding PHONE NUMBER:
MAILING ADDRESS: RAMP as above
(Street) (City/state) (Zip)
CONTRACTOR: Al.t.t) y5 AC-tivE LICENSE NUMBER: 4LWAYA *.1OloP,5
q2-2-3782
MAILING ADDRESS:
PHONE NUMBER: CIaQ?- 8500
ice-. o. K. 1915ba SiookAnic WA 99a 14
(Street)
(City/state) (Zip)
DESCRIPTION
SEWER CONNECTION
PLUMBING ALTERATIONS
SIGNATURE e
X EACH
UNIT
=AMOUNT
X50.00=
50.00
X 35.00 =
SUBTOTAL
$
EQUALS: TOTAL
PEMIT FEE DUE
=$
50.00
Spokane County Department of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509)456-3675
ra
0-' 93 71 09131 I D : TIMJRTER LOCATION.
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Sodom
rooto
amp% WA 01104-44S0
TEL N0: 201, 239 3461, 12176 P01
REGISTRATION VERIFICATION
bA4"1.643°
POO mum
SCAN St0026
PAX ace956424
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Contractor: Your Certificate of Registration will be sant from the Olympia office and
abotdd be received wiCertificate of thin to 3 weeks. Mesa keep thls mord wail yon receive your
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306
" 14