1993, 09-03 Permit App: 93007935 Sewer SEWE�PLUING I?ERMIT
APPLICATION FORM 1�3
INFORMATION0\WORKSHE ('�ET 3r73 ," "�.3.13421 12th 101S4E 22544-1315 � I
JOB STREET ADDRESS: WA 9 9 16 PARCEL NUMBER: 99216
CITY/STATE/ZIP: S okane 12th S•okane BE
13421 926
MAILING ADDRESS: PHONE NUMBER: 6796 (Zip)
OWNER: John Robin clif(Street) (City/state) trJA A+f 1(�(flP.r
P� S AC7iV E LICENSE NUMBER: AL O i=
CONTRACTOR: PHONE NUMBER: 9 a WA _ -al
ly 156Q. P4kAN (Zip)
MAILING ADDRESS: (City/state)
(Street)
X EACH =AMOUNT
UNIT
T
DESCRIPTIONRX 50.00= 1 50 T
50 .00 W `�
. 00
SEWER CONNECTION X 35.00= ; W ,` O
PLUMBING ALTERATIONS ctf CF--651—
SUBTOTAL ` ��a-
E ALS: TOTAL 85 .00 "`� irk -
p�." EE DUE _� �p�
J
SIGNATURE / CountyDepartment of Buildings
Spokane 456-3675
West 1303 Broadway Avenue Spokane,WA 99260 (509)
X10-'93 TUE 10:09 ID:LABOR & IND., SPOKANE-TEL NO:509 324 2636
r
Fibbo ruc
0176 P01
A�-10-'93 TUE 09:31 ID:TUrWATER LOCATION. TEL NO:206,239 '3461, '
t
poputment of Labor«loom REGISTRATION VERIFICATION
CosuasisZreatios Sodom
eV 110 SO J 4( i CANDOWOOS
,WA $WO444so SCAN 108226
PAX soe
E' llBair ay..j4.0.A.u.
.i _ 41116 • 0 ..
Contractor: Your Certificate of Registration will�std�you receive Your
receivedlympia office and
should be ��2 to 3 weeks. pleas km
Cadfigats of
Thank you
11e30.090.0011 Mania;vativitios 4.93 .
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