1993, 10-15 Permit App: 93009871 SewerSEWER/PLUMBING PERMIT APPLICATION FORM
q3-01-811
INFORMATION WORKSHEET g35 -g1,9
JOB STREET ADDRESS: 401 4 S WOODRUFF
CITY/STATE/ZIP: SPOKANE WA 9 9 2 1 2 PARCEL NUMBER:
OWNER: MILO HUBERT PHONE NUMBER: 928-2000 EXT. 305
MAILING ADDRESS: 401 4 S WOODRUFF SPOKANE WA 99212
(Street) (City/state) (Zip)
CONTRACTOR: FORD ' S CONSTRUCTIONLICENSE NUMBER: FORDSCC094C5
PHONE NUMBER: 924-6182
MAILING ADDRESS: 9713 E 4TH AVE SPOKANE WA 99206
(Street)
(City/state) (Zip)
DESCRIPTION
SEWER CONNECTION
PLUMBING ALTERATIONS
SIGNATURE
X EACH
UNIT
=AMOUNT
X50.00=
50.00
X 35.00 =
SUBTOTAL
$
EQUALS: TOTAL
PEMIT FEE DUE
=$
50.00
Spokane County Department of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509)456-3675