HomeMy WebLinkAbout1992, 11-30 Permit App: 92010466 Sewer SEWER/PLUMBING PERMIT APPLICATION FORM °\.
INFORMATION WORKSHEET - *�
JOB STREET ADDRESS:
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CITY/STATE/ZIP: Spar .,
c , 1,4p/,+- PAR EL NUMBER: - (-3. ,1MAILING ADDRESS: cA*i-t
OWNER: OtL+-c.r l of c L, tr- PHONE NUMBER: ct2.4 -CQg30
(Street) (City/state) (Zip)
CONTRACTOR: H S Cunst-ruc.i-i,,r, LICENSE NUMBER: HSCo J T. 4- ►Z31(F
PHONE NUMBER: 522.(0-8%L
MAILING ADDRESS: E.• 118th UawEyway Auc. SPaxAtoe, uJ A. 992-0(0
(Street) (City/state) (Zip)
XEACH
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DESCRIPTION UNIT =AMOUNT q
CI
SEWER CONNECTION X 50.00= S-<-, i SD\ l°�
PLUMBING ALTERATIONS X 35.00 = `1
SUBTOTAL $
EQUALS: TOTAL
PEMIT FEE DUE =$ cv
SIGNATURE
Spokane County Department of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509)456-3675