Loading...
1993, 02-03 Permit App: 93000597 SewerSEWER/PLUMBING PERMIT APPLICATION FORM INFORMATION WORKSHEET JOB STREET ADDRESS: C‘ 1a H (� � X111 fin" CITY/STATE/ZIP: PARCEL NUMBER: MAILING ADDRESS: X13 sc-(1 OWNER: CONTRACTOR: PHONE NUMBER: treet) (City/state) t7 (\ t LICENSE NUMBER: (Zip) PHONE NUMBER: MAILING ADDRESS: (Street) (City/state) (Zip) DESCRIPTION SEWER CONNECTION PLUMBING ALTERATIONS X EACH UNIT =AMOUNT X 50.00 = X 35.00 = SUBTOTAL $ EQUALS: TOTAL PEMIT FEE DUE =$ SIGNATURE Spokane County Department of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509)456-3675