2002, 05-08 Permit App: 02003484 SewerProject Number: 02003484 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 5/8/2002 Page 1 of 2
Project Information:
Permit Use: SEWER CONNECTION - VALLEY VISTA &
PLUMBING REVERSAL
Setbacks: Front
Left: Right: Rear:
Site Information:
.........................................
Plat Key: 000848 Name: FARR-MISSION SUB
Contact: H & 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: 45083.0446
Block:
SiteAddress: 1616 N FARR RD
SPOKANE, WA 99206
Location:: SPO
Zoning: AGSUB
Water District:
Area: 0 Sq Ft
Lot:
Owner: Name:
Address:
JEFFERY, KEITH
1616 N FARR RD
SPOKANE, WA 99206
Hold: ❑
Width: 85 Depth: 135 Right Of Way (ft): 50
Nbr of Bldgs: 0 Nbr of Dwellings: 1
Review Information: ::............................... ..............................
Review
Permits:
Add
or: UNKNOWN ► 1 pj TE-
ess: UNKNOWN V�
UNKNOWN, WA UNKNOWN
Contra
Item De
•
tion
WATER PIPING - DWV
PROCESSING FEE
MINIMUM FEE ADJUSTMENT
Plumbing Permit
Firm: UNKNOWN
Phone: (000) 000-0000
Units Unit Desc
1 NUMBER OF
1 Y OR BLANK
1 Select
Operator: RMB Printed By: RMB
Permit Total Fees:
Print Date:
Fee Amount
$5.00 Ve (`�
$25.00 �
$4.00
$35.00
5/8/2002
Project Number: 02003484 Inv: 1
Applicatiofi
THIS IS NOT A PERMIT
lties will be assessed for commencing work without a permit
Date: 5/8/2002
ntractor:UNKNOWN tiyiDA___-r,
dress: UNKNOWN
UNKNOWN, WA UNKNOWN
Item
ri i tion
SEWER CO
PROCESSING FEE
•
Payment Summary::;::::
Permit Type
Plumbing Permit
Sewer Connection Permit
Un
er Connection Permit
Page 2 of 2
Firm: UNKNOWN
hone: (000) 000-0000
Units nit 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: 5/8/2002