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2002, 07-30 Permit Application: 02006424 SewerProject Number: 02006424 Inv: I Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 7/30/02 Page 1 of 2 Project Information: Permit Use: SEWER CONNECTION - EASTON / PLUMBING REVERSAL Setbacks: Front Left: Site Information: Plat Key: 000699 Name: EASTON SUB Right: Rear: Contact: Address: C - S - Z: Phone: Group Name: Project Name: COURCHAINE CONSTRUCTION 19818 E SPRAGUE GREENACRES, WA 99016 (509) 924-5485 District: F Parcel Number: 45163.0252 Block: 2 SiteAddress: 11212 E ALKI AVE SPOKANE, WA USA 00000 Location:: SPO Zoning: UR -3.5 Water District: Area: 11,802 Sq Ft Nbr of Bldgs: 0 Review Information: Review Road Obstruction Permits: Urban Residential 3.5 Width: 0 Nbr of Dwellings: 0 Lot: 1 Owner: Name: FRENCH, GLADYS Address: 11212 E ALKI AVE SPOKANE, WA 99206 -5086 b2S (022_ Hold: ❑ Depth: 0 Right Of Way (ft): 0 Released By: Plumbing Permit Contractor: BELKNAP PLUMBING Firm: BELKNAP PLUMBING Address: 3414 S ADAMS RD Phone: (509) 921 -5913 VERADALE, WA 99037 Item Description WATER PIPING - DWV PROCESSING FEE MINIMUM FEE ADJUSTMENT Units Unit Desc 1 NUMBER OF 1 Y OR BLANK 1 Select Operator: CKF Printed By: CKF Permit Total Fees: Print Date: Fee Amount $6.00 $25.00 $4.00 $35.00 7/30/02 Project Number: 02006424 Inv: I Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 7/30/02 Page 2 of 2 Sewer Connection Permit Contractor: COURCHAINE CONSTRUCTION Firm: COURCHAINE CONSTRUCTION Address: 19818 E SPRAGUE AVE Phone: (509) 928 -0846 GREENACRES, WA 99016 Item Description SEWER CONNECTION PROCESSING FEE Notes: Units Unit Desc 1 NUMBER OF 1 Y OR BLANK Fee Amount $85.00 $15.00 Permit Total Fees: $100.00 Payment Summary: and N[ oGNo■ , Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing Plumbing Permit $35.00 $35.00 $0.00 $35.00 Sewer Connection Permit $100.00 $100.00 $0.00 $100.00 $135.00 $135.00 $0.00 $135.00 Disclaimer: Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and finds the information contained within to be true and correct, and agrees that all provisions of laws and /or regulations governing this type of work will be complied with. Subsequent issuance of a permit shall not be contrued to be a permit for, or an approval of, any violation of any of the provisions of the code or of any other state or local laws or ordinances. Signature: Operator: CKF Printed By: CKF Print Date: 7/30/02