Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
1992, 12-22 Permit App: 92011109 Plumbing Reversal
SEWER/PLUMBING PERMIT APPLICATION FORM p 5 INFORMATION WORKSHEET '�Ca S 3 JOB STREET ADDRESS: �- /Z)// - —:-- �� CITY/STATE/ZIP:. Al - 6.<-- I PARCEL NUMBER: c OWNER: YL- - PHONE NUMBER: .' ` MAILING ADD ESS: `e----- --,_-k"-----"--,"'�� (Street) (City/state) (Zip) CONTRACTOR: nOU OHRIP.E EXCAYl4Ti Ni LICENSE NUMBER: i PHONE NUMBER: q,4'.S�Bg MG V'c-2ac11. 14N- '403 MAILING ADDRESS: E. 1(0402. • Streett) (City/state) (Zip) IBMUNTO DESCRIPTION =AMOUNT SEWER CONNECTION X 50.00 = Cl i PLUMBING ALTERATIONS SUBTOTAL EMES1111111 EQUALS: TOTAL 042--c+ PEMIT FEE DUE =$ d SIGNATURE - Spokane County Department of Buildings West 1303 Broadway Avenue Spokane,WA 99260(509)456-3675 __.