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1992, 10-30 Permit App: 92009603 Sewer
SEWER/PLUMBING PEWIT APPLICATION FORM INFORMATION WORKSHEET JOB STREET ADDRESS: CITY/STATE/ZIP: OWNER: MAILING ADDRESS:_ /3Ltz ?eka CriliC PARCEL NUMBER: PHONE NUMBER:_ (Street) CONTRACTOR: A_ w4 5 ACT E MAILING ADDRESS: DESCRIPTION (City/state) (Zip) LICENSE NUMBER: A A A.*1OloP.S PHONE NUMBER: 9 a- 8500 +moo. 1415ba siookANt w4 990 (City/state) (Zip) (Street) Spokane County Department of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509)456-3675