1994, 01-11 Permit App: 94000235 Sewer ,, /tSW. q153 gl-t- -235
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SEWER/PLUMBING PERMIT APPLICATION FORM 945 -2J-1-
INFORMATION WORKSHEET
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JOB STREET ADDRESS: S 921 University
CITY/STATE/ZIP: Spokane, WA 99206 PARCEL NUMBER:
MAILING ADDRESS: same
OWNER$Ill & Joelle Candler PHONE NUMBER: 509-928-7432
(Street) (City/state) (Zip)
CONTRACTOR: A LIAM 5 ACTIVE LICENSE NUMBER: ALWAYAit*4.0be5
PHONE NUMBER: 9aa-$BOO ,
MAILING ADDRESS: Imo.0. C�. c.)•( 14 15( a 'POkANZ WA (=Malt/ '
(Street) (City/state) (Zip)
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X EACH %
DESCRIPTION UNIT =AMOUNT '"
SEWER CONNECTION X 50.00 = 50 .00 _ 416. `"
PLUMBING ALTERATIONS X 35.00= 35 .00
SUBTOTAL $
EQUALS: TOTAL
PEMIT FEE DUE _$ 85 .00
7(SIGNATURE /,'
Spokane County Department of Buildings
West 1303 Broadway Avenue Spokane, WA 99260(509)456-3675