Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
1993, 02-09 Permit App: 93000735 Sewer
\5 •SQ\,Zo 0- z a�feS\ 1--'` SEWER/PLUMBING PERMIT-APPLICATION FORM ��S_ oZ5 N INFORMATION WORKSHEET 3' 5 5 JOB STREET ADDRESS: S • -2_0(•)‘-i Ice-. c_3 `"� CITY/STATE/ZIP: c.-*-). ..r._ ) u r0 J PARCEL NUMBER: MAILING ADDRESS: -SA Lte- OWNER: )c{tea Kin;‘L.,--- PHONE NUMBER: c;2.X-Co5 iLt (Street) (City/state) Pp) CONTRACTOR: H£S Gans{-rucl-icon LICENSE PHONE NUMBER:NUMBER: SC ,J 4 4- t Z3 K F. MAILING ADDRESS: a• 1121-1 UALLey dAy AuE. SPeKAA)e, UJ A• 97_0(0 (Street) (City/state) (Zip) X EACH DESCRIPTION UNIT =AMOUNT ` ( (aG(e,5 LSEWER CONNECTION X 50.00= c,� �I PLUMBING ALTERATIONS X 35.00= SUBTOTAL $ EQUALS: TOTAL PEMIT FEE DUE _$ C v SIGNATURE ( .1=' 1 Spokane County Department of Buildings West 1303 Broadway Avenue Spokane,WA 99260(509)456-3675