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1992, 10-14 Permit App: 92008866 Sewer OCT 1: '92 11.015AM PON SLOAN FH; ' SS4JG1r F'. SEWER/PLUMBING PER4.MIT APPLICATION CORM cia S' 1 N 5 INFORMATION WORKSHEET c2- e)07c0 girl l3 =� JOB STREET ADDRESS \�N�P�S� ARCEL NUMBER:---------- CITY/STATE/ZIP: p`C' PHONE NUMBER: OWNER: (Zip) MAILING ADDRESS:_-----(Street) (Citytstate) A iP) 5 AC-f til LICENSE NUMBER:. CONTRACTOR: PHONE NUMBER W q9a O. L6p>L 14l5b _ S•PQk' NE (Citytstate) Rip) MAILING ADDRESS: (Street} __ __-- !�_��,.�, OG ,ate X EACH � 0) �� UNIT wAMOUNT pESCRIpTtON X g4,40 =� _ SEWER CONNECTION X 35.00 - — _ v�� ` PLUMBING ALTERATIONS SUBTOTAL $ EQUALS: TOTAL 0 PEM{T FEE DUE j`_' SIGNATURE— __Spokane County Department of Buildings 55 3675 Avenue Spokane,WA 99260 (509)4 _ ! _ - - _ _ West13438roadway - _ _ - _ _ ^ - - - - - - - - -