The URL can be used to link to this page

1992, 11-13 Permit App: 92010088 Sewer SEWER/PLUMBING PERMIT APPLICATION FORM 0° 2) INFORMATION WORKSHEET JOB STREET ADDRESS: / '9r . ,. /6-7.74)6 a,�C� CITY/STATE/ZIP: Bi//� PARCEL NUMBER: 7 \ OWNER: 5 . Q f� PHONE NUMBER: AdD MAILING ADDRESS: ° .. .� (Street) (City/state) (Zip) CONTRACTOR:/ • � , / . , LICENSE NUMBER: q PHONE NUMBER: /022 -0 �P j7 Q' s � 9%2/6.MAILING ADDRESS: /g U/‘ � �� / VEa�(Street) (Cistate) (Zip) X EACH DESCRIPTION UNIT =AMOUNT \i ,r (r? e 1 �C o') SEWER CONNECTION X 50.00= -S0 , 0 0 a��'\� V_ PLUMBING ALTERATIONS X 35.00 = '� -0 0 00 eC SUBTOTAL $ EQUALS: TOTAL _ Pi(C� 1� PEMIT FEE DUE =$ -� , 0 0 , ., b SIGNATURE . ac-e,?..doe..--t---2.-&-e--,. Spokane County Department of Buildings West 1303 Broadway Avenue Spokane, WA 99260(509)456-3675 4