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1992, 10-15 Permit App: 92008913 Sewer
YwAfi f. 6 cG led SEWER/PLUMBING PERMIT APPLICATION'/F AAs( INFORMATION WORKSHEET JOB STREET ADDRESS: C >/� �l/ — E �t � CITOSTATWIP:j 9� PARCEL NUMBER: A �b'O J"Sl OWNER:✓�R��-Q e� PHONE NUMBER: MMUNG ADDRESS: L—/: /0517 (Street) (Cltyhlate) (Lp) CONTRACTOR: U R xAI m AyATbN LICENSE NUMBER: aujeccaklele-I OI\3 PHONENUMB�ER: c9p4-5486 MAILING ADDRESS: E U (6402 VREy R AW Assiluh 94057 /a � (Sveeq (City/Mate) (ap) '- XEACH o�=DMa DESCRIPTION UNIT MMOUNT S . SEWER CONNECTION X80A0= PLUMBING ALTERATIONS Xa5.B0— _ SUBTOTAL $ EQUALS: TOTAL PEMIT REEDUE 4 SIGNATURE /4� Spokane Canty Depalunent of BuiMings West 1303 Broa0 cay Avenue Spokes. WA 99289 (509)456S 5