Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
1992, 09-16 Permit App: 92007689 Sewer
SEWER/PLUMBING PERMIT APPLICATION FORM INFORMATION WCSKSHEET JOB STREET ADDRESS: e---- /-- -�-/t--' -,cam- /01 -'e --"if ` keA C/- t CITY/STATE/ZIP: .}.d -Ge 'd° " PARCEL NUMBER: _ - CA �. ,3 ci MAILING ADDR SS: �--�<< > � �- -�- --- OWNER: Ct f_' 7Z_e Vi 7 PHONE NUMBER: % "- / t4 1 `^. -1 (Street) (City/state) (Zip) CONTRACTOR:CoueakAiNE EXCAviVriot LICENSE NUMBER: COL' ecC.AkISA 4'7 " ti PHONE NUMBER: c1a4-6455 i MAILING ADDRESS: E. UoLlo,2 UAI.LywAV AWE Vee bAt WA- 439037 (Street) (City/state) (Zip) DESCRIPTION SEWER CONNECTION PLUMBING ALTERATIONS X EACH UNIT =AMOUNT X 50.00 = - �:1 X35.00= SUBTOTAL $ -i' `p �"' EQUALS: TOTAL PEMIT FEE DUE =$ .- , -Z) J SIGNATURE r L cc c'_,(-7y7.6Z� ,,___L--_, Spokane County Department of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509)456-3675