1993, 09-14 Permit App: 93008350 Sewer PERMIT APPLICATION3- S3
SEWER/PLUMBING FORM a
INFORMATION WORKSHEET
JOB STREET ADDRESS:
E. 14715 16th Veradale 4 " I 6159125
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CITY/STATE/ZIP: Wp. Agn37 PARCEL NUMBER:
Ve rada
OWNER: Leonard H. Sohn Gnn—
PHONE NUMBER: 9 2 7-'93-----_
MAILING ADDRESS: 'a :• - _
(Street) (City/state) (Zip)
CONTRACTOR: Al.t t) `IS AC?!v E LICENSE NUMBER: A A 5�10(oP5
PHONE NUMBER:
+moo �o>L /415ba S4PokAN€ Wft 99.D14
MAILING ADDRESS: (Street) (City/state) (Zip)
X EACH 9�
DESCRIPTION \X".UNIT =AMOUNT
SEWER CONNECTION X 50.00 = II M
PLUMBING ALTERATIONS X 35.00=
SUBTOTAL
EQUALS: TOTAL 50 . 00
PEMIT FEE DUE =.$
SIGNATURE A, 4.4. L.
,k—Spokane County Department of Buildings
West 1303 Broadway Avenue Spokane, WA 99260(509)456-3675
89x31 1D:TuiI TER LOCATION. TEL NO:20�i, 239 5461, t$146
• 03 P01 •
oaddlag« REGISTRATION VERIFICATION
osagoarjiN ieodo• ►, • •
Zaps W' 9$04414.10 � (104 9364236
ICAN 204226
PAX 606)950422$
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Contractor: Your Certificate of Registration will be sent from the Olympia office and
withinshould be recolvcd 2 to 3 weeks. Pleas keep this record wndl you receive your
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