1993, 06-24 Permit App: 93005108 Sewery5'z13.Z3o 7
n SEWER/PL MBING PERM!TAPPLICATION FORM g,j ' 5IOg
i l crcC Q -d 6 INFORMATION WORKSHEET
JOB STREET ADDRESS: 11015 E. 10th Avenue
CITY/STATEOP: Spokane, WA 99206 PARCEL NUMBER:
MAILING ADDRESS:
OWNER: Nguyen PHONENUMBER: 924-6199
(Street) (City/state) (Zip)
CONTRACTOR: AL.UA9S ACTIVE LICENSENUMBER: AL.WAYAe.±0lo P5
PHONE NUMBER: 9da-85DU
MAILING ADDRESS: 1�.0 • ana r4 z sroa S POkAMG WA 99.174 '
(Street) (City/state) (Zip)
X EACH
(UNIT
=AMOUNT
_
X50.00=
$50.00
X 35.00 =
SUBTOTAL
$ 5977u -
EQUALS: TOTAL
PEMIT FEE DUE
_$ 50.00
t4 -f' 'M +1. N (I Ll -go
Spokane County Department of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509)456-3675