1994, 02-03 Permit App: 94000875 Sewer 5z3q, to4SEVVER/PLUMBING PERMIT APPLICATION FORM
J�� �r� � � `?� INFORMATION WORKSHEET 91-t/5 CO,�
JOB STREET ADDRESS: 14820 E 14th
CITY/STATERIPPokane WA 99-21:6 PARCEL NUMBER:
MAILING ADDRESS: 13119 E Semro , Spokane, WA 99216
OWNER:Arthur C.Sharpe PHONE NUMBER: 928-7674
(Street) (City/state) (Zip)
CONTRACTOR: A LLAJAy 5 ACTIV E LICENSE NUMBER: A LI4A)f Alf L P°.�
PHONE NUMBER: 9A7a-BSOO
MAILING ADDRESS: 1�- .Q. �t o� Al 1510a PQ)CANE WA jtalq
(Street) (City/state) (ZiiP)
X EACH
DESCRIPTION UNIT =AMOUNT
SEWER CONNECTION X 50.00= , , ,
PLUMBING ALTERATIONS _X 35.00= 3 5 .0 0
SUBTOTAL A 85 .00
EQUALS: TOTAL
PEMIT FEE DUE 85 .00
SIGNATURE '�t ��`
Spokane County Department of Buildings
West 1303 Broadway Avenue Spokane, WA 99260(509)456-3675