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2002, 01-07 Permit Application: 02000090 Sewer Connect, Plumbing ReversalProject Number: 02000090 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: SEWER CONNECTION - EASTON & PLUMBING REVERSAL Date: 1/7/2002 Page 1 of 2 Setbacks: Front Left: Right: Site Information: .................... . Plat Key: 001834 Name: OPP.TR. 1 -354 Rear: Contact: II & S CONSTRUCTION Address: 11817 E. VALLEYWAY AVE C - S - Z: SPOKANE WA 99206 Phone: (509) 926 -8964 Group Name: Project Name: District: F Parcel Number: 45163.0124 Block: 1 SiteAddress: 11303 E ALKI AVE SPOKANE, WA USA 00000 Location:: SPO Zoning: UR 3.5 Urban Residential 3.5 Water District: Area: 12,103 Sq Ft Width: 0 Nbr of Bldgs: 0 Nbr of Dwellings:. 0 Review Information: :::............_...................... ............................... Lot: 5 Owner: Name: POLAND, GLORIA J Address: 2907 E 15TH AVE SPOKANE, WA 99223 -5105 Hold: ❑ Depth: 0 Right Of Way (ft): 0 Review Road Obstruction Permits: Released By.�'"` #i Contractor: JACKSON PLUMBING Address: P.O. BOX 7272 SPOKANE, WA 99207 Item Description WATER PIPING - DWV PROCESSING FEE MINIMUM FEE ADJUSTMENT Plumbing Permit Firm: RANDY JACKSON PLUMBING Phone: (509) 926 -7101 Units Unit Desc 1 NUMBER OF 1 Y OR BLANK 1 Select Operator: RMB Printed By: RMB Permit Total Fees: Print Date: Fee Amount $6.00 $25.00 $4.00 $35.00 1/7/2002 Project Number: 02000090 Inv: I Applicztion THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 1/7/2002 Page 2 of 2 Sewer Connection Permit Contractor: H & S CONSTRUCTION Firm: 11 & S CONSTRUCTION Address: 11817 E VALLEYWAY AVE Phone: (509) 926 -8964 SPOKANE, WA 99206 Item Description SEWER CONNECTION PROCESSING FEE Notes: Payment Summary ::;.: Permit Type Plumbing Permit Sewer Connection Permit Units Unit Desc 1 NUMBER OF 1 Y OR BLANK Permit Total Fees: Fee Amount Invoice Amount $35.00 $35.00 $100.00 $100.00 $135.00 $135.00 Fee Amount $85.00 $15.00 Amount Paid $0.00 $0.00 $100.00 Amount Owing $35.00 $100.00 $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: RMB Printed By: RMB Print Date: 1/7/2002